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Temple Beth David Shalom Corner Early Learning Center Interest Form
Please verify reCaptcha before submitting the form.
Please share some information about your needs.
*
Your First Name
*
Your Last Name
*
Email Address
Telephone Number
*
Your town
*
When do you want your child(ren) to start? MONTH and YEAR
*
First and Last Name of 1st Child
*
First Child's Birthday
Gender
Male
Female
First and Last Name of 2nd Child
Second Child's Birthday
Gender
Male
Female
First and Last Name of 3rd Child
Third Child's Birthday
Gender
Male
Female
*
How many days are you requesting?
5 Days (required for Alim)
3 days (M-W-F)
2 Days (T and Th)
*
What schedule interests you?
Half Day 8:00-1:00
Full Day 8:00-5:30
Other
If other, please explain your schedule needs.
Where did you hear about Shalom Corner?
Please share questions you have for us:
Please let us know the best way and times to reach you.
Sat, February 22 2025 24 Sh'vat 5785