2025-2026 Beth El Early Learning Center New Family & Stand-by-Status List Application

PARENT 1 INFORMATION

Title

* First Name

* Last Name

Hebrew Name (if Jewish)

Please use English letters

Nickname

* Gender

* Email

* Cell Phone - Enter as: (xxx) xxx-xxxx

* Can we use your cell phone for texting services?

* Date of Birth

* Marital Status

If Married, Date of Marriage

HOME ADDRESS

* Street Address 1

Street Address 2

(Enter Apt #, Suite #, etc)

* City

* State

* Zip Code

Subdivision

Home Phone - Enter as: (xxx) xxx-xxxx

Please do NOT enter CELL #

* Is this HOME address the same as the BILLING Address?

BILLING ADDRESS

Billing Street Address 1

Billing Street Address 2

(Enter Apt #, Suite #, Etc)

Billing City

Billing State

Billing Zip Code

Billing Phone - Enter as: (xxx) xxx-xxxx

BUSINESS INFORMATION

* Are you Retired?

* Occupation

* Employer Name

Business Phone

Business Email

RELIGIOUS BACKGROUND

* Religious Background

* Jewish Affiliation

Previous Synagogue & Location

Other Religious Affiliation

Non-Jewish Denomination

PARENT 2 INFORMATION

Title

First Name

Last Name

Date of Birth

Hebrew Name (if Jewish)

Please use English letters

Nickname

Gender

Email Address

(Please use a different email address than specified for Parent 1)

Cell Phone - Enter as: (xxx) xxx-xxxx

Can we use your cell phone for texting services?

Is home address for Parent 2 same as for Parent 1 ?

HOME ADDRESS (Parent 2)

Street Address 1

Street Address 2

City

State

Zip Code

Subdivision

Home Phone - Enter as: (xxx) xxx-xxxx

Please do NOT enter CELL #

RELIGIOUS BACKGROUND

Religious Background

Jewish Allfiliation

Previous Synagogue & Location

Non-Jewish Denomination

BUSINESS INFORMATION

* Are you Retired?

* Occupation

* Employer Name

Business Phone

Business Email

ENROLLMENT and CHILDREN INFORMATION

Temple Beth El Family Membership is included with your enrollment.

Click here for tuition prices.

*
How many children do you plan to enroll in our program?

* Child-1 First name

* Child-1 Last name

Child-1 Hebrew name (if applicable)

* Child-1 Date of birth

* Child-1 Gender

* Schedule options for Child-1

* Child-2 First name

* Child-2 Last name

Child-2 Hebrew name (if applicable)

* Child-2 Date of birth

* Child-2 Gender

* Schedule options for Child-2

* Child-3 First name

* Child-3 Last name

Child-3 Hebrew name (if applicable)

* Child-3 Date of birth

* Child-3 Gender

* Schedule options for Child-3

* Child-4 First name

* Child-4 Last name

Child-4 Hebrew name (if applicable)

* Child-4 Date of birth

* Child-4 Gender

* Schedule options for Child-4

ADDITIONAL CHILDREN INFORMATION

If you have any children living in your household, other than the child(ren) you are currently applying for, please list their information by clicking on the BLUE "+" (plus sign) below.
*** Click the BLUE "+" (plus sign) each time to enter each child

Child's First Name

Child's Last Name

Gender

Child's Hebrew Name (if applicable)

Date of Birth

Bar/Bat Mitzvah Date

Grade 2024-2025 School Year

Name of School

In order to keep your child engaged and informed regarding Temple activities, please provide the following information:

Child's Mobile Phone - (xxx) xxx-xxxx

Child's Email Address

Have any of your children previously attended the Beth El Early Learning Center?

If YES, please list their names below

First Name

Last Name

First Name

Last Name

First Name

Last Name

Have any of your children previously attended our Summer Adventure Camp?

If YES, please list their names below

First Name

Last Name

First Name

Last Name

First Name

Last Name

Has your child participated in Mommy & Me classes at the Beth El Early Learning Center, either currently or during the spring or fall 2024 sessions?

If YES, please list their names and the session(s) they attended below

First Name

Last Name

Session and Date Attended (ex: Spring 2024)

First Name

Last Name

Session and Date Attended (ex: Spring 2024)

First Name

Last Name

Session and Date Attended (ex: Spring 2024)

Were any of your children placed on the Stand-By-Status List for the 2024-2025 school year?

If YES, please list their names below

First Name

Last Name

First Name

Last Name

First Name

Last Name

If we can only accommodate one of your children, would you be willing to enroll one and place the other on the Stand-By-Status List, or is enrolling both children necessary for your participation?

OTHER PEOPLE IN HOUSEHOLD

* Other than your child(ren) and yourselves, does anyone else reside in your household?

If YES, please list their names below

First Name

Last Name

Relationship to you

First Name

Last Name

Relationship to you

TEMPLE MEMBERSHIP

Please tell us how you found us?

* Have you ever been members of TEMPLE BETH EL in the past?

* Have you belonged to any other synagogue during the past 24 months?

* Name of synagogue

* Do you or your spouse have any relatives who are current members of TEMPLE BETH EL?

Example: Parents, grandparents, aunts, uncles, cousins, etc
If so, please list their names below

First Name

Last Name

Relationship

First Name

Last Name

Relationship

First Name

Last Name

Relationship

ADDITIONAL INFORMATION

* Do you acknowledge and agree to the following policy regarding immunizations?

Please be advised prior to enrollment that we require all students that attend the Beth El Early Learning Center to be fully immunized as required by the Florida Department of Health. We do not accept Religious Exemptions, but will consider Medical Exemptions as provided by your child’s pediatrician on the Certificate of Immunization (Form DH680).

So that we may best serve your child’s needs please share with us any therapy services that your child receives for developmental needs?

Is there anything you’d like us to know about your child, your family, or your goals for their early learning experience? Feel free to share any unique qualities, interests, or additional information that can help us better understand and support your family.

* Parent 1 - Please sign your application electronically (Full Name) here:

Parent 2-Please sign your application electronically (Full Name) here:

Tue, July 1 2025
5 Tammuz 5785

Upcoming Programs & Events

Jul

Sisterhood: Book, Brunch & Mimosas
Sunday, Jul 13 11:00am

Aug

The Giving Tree Back to School Program - Pack the Bag
Sunday, Aug 3 9:00am

Aug

Adult B'nai Mitzvah - Information Session
Wednesday, Aug 6 7:00pm

Aug

Tu B'Av Shabbat at the Movies
Friday, Aug 8 7:30pm

Aug

ELC New Family Meet & Greet
Saturday, Aug 16 9:30am

Fast of Tammuz

Sunday, Jul 13

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Zmanim

Alot Hashachar	5:11am
Earliest Tallit	5:43am
Netz (Sunrise)	6:31am
Latest Shema	9:57am
Zman Tefillah	11:06am
Chatzot (Midday)	1:24pm
Mincha Gedola	1:59pm
Mincha Ketana	5:25pm
Plag HaMincha	6:51pm
Shkiah (Sunset)	8:17pm
Tzeit Hakochavim	8:56pm
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Tue, July 1 2025 5 Tammuz 5785

Temple Beth El

SCHAEFER FAMILY CAMPUS

333 SW 4th Avenue
Boca Raton, FL 33432
Tel: 561-391-8900
Fax: 561-395-8913

BETH EL EARLY LEARNING CENTER
BECK FAMILY CAMPUS

9800 Yamato Road
Boca Raton, FL 33434
Tel: 561-391-9091

About the Temple

Temple Beth El is a reform synagogue seeking to inspire a passionate commitment to Jewish life, learning, community and spiritual growth.

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