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Temple Emanuel ECC Application Form
Please verify reCaptcha before submitting the form.
Please complete and submit one Application form per child. A $200 non-refundable application fee must accompany each application.
Applications are a request for enrollment consideration
only
and do not indicate enrollment or a contract of acceptance. Contracts will be offered to ECC siblings and Temple members during the priority enrollment period. Following that, new families will be offered enrollment contracts on a first come, first served basis.
Today's Date
Temple Emanuel Member
Yes
No
Child Information
Last Name
First Name
Birth Date
Pronouns
Sibling will also be enrolled
No
Yes
Sibling's name
Enrollment Contract
Full-Day
Half-Day
[Limited Half-Day Contracts will be available for the 25-26 School Year]
Parent/Guardian 1
Last Name
First Name
Pronouns
Email
Street Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Home Phone
Work Phone
Cell Phone
Parent/Guardian 2
Last Name
First Name
Pronouns
Email
Street Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Home Phone
Work Phone
Cell Phone
Your Child's age as of 9/1:
Years Old
Months Old
*
Application Fee ($200)
Application Fee ($200)
Fri, February 14 2025
16 Shevat 5785
Fri, February 14 2025 16 Shevat 5785