South Peninsula Hebrew Day School
The Best Place for a Jewish Mind
 

Student Application for Admission of the School Year  
Child's Name                    Hebrew Name 
  Last       Initial First
Date of birth  / / Place of birth  Gender M F
   MM       /  DD        /  YYYY                                                     City          &nbsp Zip Code
Child's Primary Language    Other Languages 
Home Address   Present Grade
          Street                    City                    State            Zip code
Father's Name    Hebrew Name    Ben 
Last  Initial First
Home Address  Home Phone 
         (if different than above)    Street            City             State         Zip code
E-mail  Cell Fax
Employer  Occupation 
Employer's Address    Business Phone 
          Street                    City                    State            Zip code
Mother's Name    Hebrew Name    Bat 
Last  Initial First
Home Address      Home Phone 
         (if different than above)    Street            City             State         Zip code
E-mail  Cell Fax 
Employer  Occupation 
Employer's Address    Business Phone 
         Street                    City                    State            Zip code
Child lives with Mother    Father    Both parents    Both parents in separate homes
Check if applicable Mother Deceased Father Deceased Separated
  Mother Remarried   Father Remarried   Divorced
Synagogue Affiliation 
Present School Name     Present School Phone 
Present School Address 
          Street                    City                    State            Zip code
 
Names of other children in family and school(s) attending:
          Name      Boy  Girl      Age      School
          Name      Boy  Girl      Age      School
          Name     Boy  Girl      Age      School
          Name      Boy  Girl      Age      School
 
 

The following is an integral part of the application for 
and must be completed in full.
1.  Spoken English   Fluent     Limited     None
     Written English Fluent Limited None
     Spoken Hebrew   Fluent Limited None
     Written Hebrew Fluent Limited None   
2.  Does your child have any special educational needs?     Yes     No
     Does your child have any special medical needs? Yes No
     Does your child have any special emotional needs? Yes No
3.  If yes, please give details.
4.  For 3 year-old program: Is the child potty-trained?    Yes     No
5.  Is there any other information about your child that you would like to share with us?
6.  For 2 year old and 3 year old programs only, please check one:    3 days    5 days    Not applicable  

Age Requirements:
  2-year-old program must be 2 by September 1,
  Kindergarten applicants must be 5 by November 1,

      
PLEASE NOTE: This application is not complete unless accompanied by:
  1. A $75 non-refundable application fee.
  2. a. Previous year(s) report cards.
    b. Transcripts, including academic achievement, social, emotional and behavioral,
        must be sent directly from previous school(s).
  3. The Pre-School evaluation form (for Kindergarten applicants only).
      
I hereby apply for my child, ,
Child痴 Name
to attend South Peninsula Hebrew Day School.
I understand that this is an application for registration and does not guarantee acceptance.
I authorize to forward all records requested by SPHDS
School痴 Name
in order to evaluate this application.
  
Signature of Parent/Guardian      Date

 

 

Please complete this form and send it.  A copy should be printed (2 pages), signed and mailed with the $75 application fee to:

Registrar
SPHDS
1030 Astoria Drive
Sunnyvale, CA 94087
Phone (408) 738-3060        Fax (408) 738-0237
 

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