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Preliminary Preschool Application

Preliminary Preschool Application

This is a Preliminary application once submitted Mrs. Chaya Berkowitz will contact you to set up a meeting.

Student Information

First Name Last Name
Address Phone
City Zip Code
DOB Email
Family Orientation
Father's Name Occupation
Business Address Business Phone
City . Zip
Mother's Name Occupation
Business Address Business Phone
City Zip
Siblings
Name DOB
Name DOB
Name DOB
Medical Information
Physician Phone
Address City, Zip
List Any Allergies Your Child Has
In Case of Emergency Contact
Name Do They Drive
Address Phone
City Zip
Name Do They Drive
Address Phone
City Zip
Tuition Payment Schedule and Terms
  • Chabad of Contra Costa's Preschool 2016-2017 is a 10 month program billed September 1 - June 1. Our summer program runs separately.
  • Tuition is annual. As a courtesy, we allow you to pay monthly, September to June.
  • Monthly payments are due the first week of every month

$3000 / $300/ 2-day - Yearly/Monthly
$4200 / $420/ 3 days- Yearly/Monthly
$6000 / $600/ 5 days- Yearly/Monthly

Early Care and After Care is additional

I accept these terms of enrollment

Parents Name Date

PLEASE MAKE CHECKS PAYABLE TO CHABAD

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