Bnos Shaina Admission Application 2027-2028

Student Information

Applying for grade

Section 1 | Applicant

Last Name

First Name

Hebrew Spelling

Date of Birth

Hebrew Birthday

SSN

U.S. Citizen

Yes

Previous education (list all schools, playgroups and daycare programs)

Languages spoken at home

List some of your child's hobbies

Has your child experienced any serious illnesses or accidents?

List any special needs of which we should be aware

Has your child ever received, or is your child currently receiving, any support services? Please specify

Allergies

Section 2 | Family

Marital Status

Last Name*

Home Phone

Address

Address 2

City

State

Zip

Family Rav (name and phone number)

Father

Fathers Name

Fathers Phone

Fathers Email

Father's Shul Affiliation (list shul name, shul rav, rav's phone number)

Father's Occupation

Father's Business Name

Father's Business Address

Father's Business Phone Number

Mother

Mothers Name

Maiden Name

Mothers Phone

Mothers Email

Mother's Shul Affiliation (list shul name, shul rav, rav's phone number)

Mother's Occupation

Mother's Business Name

Mother's Business Address

Mother's Business Phone Number

Siblings

Sibling 1 (please list sibling's name, age, school, grade or year of graduation)

Sibling 2 (please list sibling's name, age, school, grade or year of graduation)

Sibling 3 (please list sibling's name, age, school, grade or year of graduation)

Sibling 4 (please list sibling's name, age, school, grade or year of graduation)

Grandparents

Paternal Grandparents (please list name, mailing address and phone number)

Maternal Grandparents (please list name, mailing address and phone number)

Section 3 | Other

If applicable, what is the reason for transferring to Bnos Shaina?

What attracted you to Bnos Shaina?

Please list two references:

Reference 1 (please list name, relationship and phone number)

Reference 2 (please list name, relationship and phone number)

The following must be attached (or emailed to [email protected]) for the application to be considered:

Recent photo of your child

A copy of your child's birth certificate

Child's immunization records

Recent photo of your child

Uploading...

Copy of your child's birth certificate

Uploading...

Child's immunization records

Uploading...

I hereby give permission for Bnos Shaina to contact my child's previous school

I hereby apply for my child's admission to Bnos Shaina School for Girls and am enclosing all requested documents. I authorize my child's current school to release all relevant information, including academic, social, and health records, to Bnos Shaina. All information received will remain confidential.

Father's Signature

Mother's Signature