Temple Beth David Shalom Corner Early Learning Center Application 2026-2027 - Form

2026-2027 (School year)

Five-day & full day applicants will receive priority in each category.
Five, three, and two-day options for children in Shemesh (twos) and Keshet (threes) including the choice of half day or full day. The Pre-K class (fours) is a five-half-day program, with the option of full day until 5:30 pm.

A $550 payment ($50 non-refundable registration fee and $500 deposit) is due with your application. The deposit is non-refundable and non-transferable unless we do not offer a space to your child, in which case the $500 deposit will be returned. An additional non-refundable and non-transferable deposit of $1,000 is due with your signed enrollment agreement by April 1st for new students and by May 1st for returning students.

The $1,500 deposit is NOT refundable if a family later chooses to defer entry, to not enroll their child, or withdraws their child from Shalom Corner. If Shalom Corner is holding a slot for a child whose entrance is delayed, then tuition must be paid for the time period prior to the child’s entrance. Once the program has reached capacity, any remaining children will be wait-listed and their $500 deposit will be refunded.

Student Information

* Today's date

* Child's first name

* Last name

Nickname

* Birthday

* Child's age on September 1st, 2026

(years/months)

* Home address

* City

* Zip code

* Phone number to call first

* Primary email address

Identifying Information (required by Department of Early Education and Care regulations)

* Eye color

* Hair color

* Height

* Weight

* Primary language spoken at home

* Identifying marks

* Gender

* Skin Color

Other languages spoken at home

Family Information

* Name of Parent/Guardian 1

* Relationship to Child

Home address, if different from child's

City

State

Zip code

* Cell phone

* Email address

Type of Work

Business Name/Address

Work phone

Work hours

Name of Parent/Guardian 2

Relationship to Child

Home address, if different from child's

City

State

Zip code

* Cell phone

* Email address

Type of Work

Business Name/Address

Work phone

Work hours

Parental Marital status

Custody Agreement on File

N/AYesNo

Members of Family

Names and Birth Dates of other children in household

Others living with family

* Synagogue Membership

Please Select OneMember of Temple Beth DavidInterested in more information about Temple Beth David membershipWe are currently members of another congregationWe are not members of a synagogue

* Is your family new to Shalom Corner or are you re-enrolling?

Please Select OneNewRe-enrollingThis child is new to Shalom Corner, but our family is not.

Program selection

Enrollment is confirmed only with written verification from the Executive Director.

We try to accommodate all students as the schedule and program capacity allows. Five day applicants will receive priority. Schedule variations will be accommodated as space allows beginning on May 1st 2026.

* Class

Please Select OneShemesh/Sun (age 2 by September 1st)Keshet/Rainbow (age 3 by September 1st)Alim/Leaves (age 4 by September 1st) - Must select 5 half or full days

* Requested Daily/Weekly Schedule

Please Select One5 days Half day (8:00-1:00)5 days Full day (8:00-5:30)3 days - Monday, Wednesday, Friday - Half day (8:00-1:00)3 days - Monday, Wednesday, Friday - Full day (8:00-5:30)2 days - Tuesday, Thursday - Half day (8:00-1:00)2 days - Tuesday, Thursday - Full day (8:00-5:30)

Please let us know if you have other scheduling requests. Placement will be based on availability of space at the discretion of the staff.

* Click to pay your non-refundable, non-transferable $50 Registration Fee. The payment screen will appear after you click "Submit" at the end of the form.

Click to pay your non-refundable, non-transferable $50 Registration Fee. The payment screen will appear after you click "Submit" at the end of the form.

* Click to pay your $500 Deposit. This deposit is non-refundable and non-transferable unless we do not offer a space to your child, in which case it will be returned. The payment screen will appear after you click "Submit" at the end of the form.

Click to pay your $500 Deposit. This deposit is non-refundable and non-transferable unless we do not offer a space to your child, in which case it will be returned. The payment screen will appear after you click "Submit" at the end of the form.An additional $1,000 deposit is due by April 1st for new students and by May 1st for re-enrolling students.

* My electronic signature below represents the commitment to paying the full year’s tuition as indicated by my program selection(s) on this application.

My electronic signature below represents the commitment to paying the full year’s tuition as indicated by my program selection(s) on this application.Click here to view current tuition rates for 2025-2026. Tuition rates for 2026-2027 will be available in the spring. There is typically a 3-5% increase.

PARENT NAME

Valid for one year