Membership Registration Test

Parent 1

Name *

First

Last

Address *

City *

State *

Zip Code *

Home Phone *

Cell Phone *

Work Phone *

Email *

Parent 2

Name *

First

Last

Address (if different) *

City *

State *

Zip Code *

Home Phone *

Cell Phone *

Work Phone *

Email *

News, Photo & Media Release

Temple Emanu-El may take pictures of your child in order to promote awareness of the Temple Emanu-El Religious School. These photos could be used internally for school bulletin boards or they may be published in the Temple Bulletin, Temple website, Temple Facebook page or local newspapers.

Please select "yes" or "no" for each statement below:

Individual Learning Information

Please tell us how your child learns and if you have any particular information that would help us to make your child’s learning experience here more successful. All information will be kept confidential and only those teachers who work directly with your child will see this information.

Does your child have an IEP in public school? *

Yes No

If yes, may we have a copy to give to teachers? *

Yes No

Does your child have any special learning needs? *

Yes No

If yes, please tell us about them: *

Does your child have any special behavioral/social needs? *

Yes No Option 3

If yes, please tell us about them: *

Does your child need special seating in the classroom? *

Yes No

If yes, where? *

Front Back Middle

Is there anything we should know about your child’s learning style? What works well? What does he/she have trouble with? *

How can we help your child have a successful year? *

Would you like to speak with Debbi or your child’s teacher before school begins? *

Yes No

If yes, phone number and best time to reach you: *