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Application for Enrollment

Date*  
Gender*  
Applying for Grade*  
Student's Name*  
Student's Social Security Number*  
Student's Nickname  
Student's Hebrew Name  
Student's Birth Date*  
Student's Age*  
Phone Number*  
Street Address*  
City*  
State*  
Zip*  
Parents - Same Household  

Parent 1

Name*  
Hebrew Name  
Email*  
Profession  

What is your current profession?

Employer  
Work Phone  
Cell Phone  
Parent 2  

Parent 2 info

Name  
Hebrew Name  
E-Mail  
Profession  

What is your current profession?

Employer  
Work Phone  
Cell Phone  
Parent - Different Household  

Parent in a different household

Name  
Street Address  
City  
State  
Zip  
Hebrew Name  
E-Mail  
Profession  
Employer  
Work Phone  
Cell Phone  
Part 2  

 Student info.

To whom should all correspondence, bills and notices be sent?*  
School last attended*  
Dates attended*  
School Street Address*  
City*  
State*  
Zip*  
Director/Teacher  
Previous Hebrew / Judaic Background*  
Synagogue Affiliation  
Family Information  
How many children in family?*  
Birth order of child*  
Brothers and Sisters  
Name  
Birth date  
Name  
Birth date  
Name  
Birth date  
Name  
Birth date  
Languages spoken at home* Help Tip
LIBRARY   SELECTED  
Add to Selection

Remove from Selection
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If you selected 'other' above  

Please list any additional languages spoken at home

Grandparents  
Name  
Address  
Name  
Address  
Name  
Address  
Name  
Address  
I chose the EPJA because...*  
I have knowledge/expertise in or would like to volunteer with...  
Confirmation of Application*  

I hereby apply for admission for my child for the school year beginning August 2018

Signature/Typed name* Help Tip

All the information in this application is true, complete, and correct. I understand that the admissions packet is not complete until this application, the Confidential Teacher Recommendations, transcripts, and student records from previous schools have been received by El Paso Jewish Academy. No action will be taken on this application until the packet is complete. The EPJA reserves the right to deny admission to any applicant or to drop or expel any enrolled student if the admission or continued enrollment jeopardizes the student’s educational and emotional needs or infringes or could infringe on the school’s educational and/or discipline standards as set forth in policy.  The final determination will be in the sole judgment of the Head of School.

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"Signed on"*