School Of Leadership
1 Step 1 Step One – Child Information Child First Name Child Middle Name Child last Name Hebrew Name GenderGenderMaleFemale Child’s Date of Birthdate_range Applying for ClassApplying for Class2s-3s (PG-N) 4s-6s (PreK-1st) Academic Start YearAcademic Start Year2022-2023 Please Upload Photo of Childcloud_uploadPlease Upload Photo of Child Please Upload Child’s Birth Certificatecloud_uploadPlease Upload Child’s Birth Certificate Please email if you cannot upload the image Home Address City State Zip Home Phone Languages spoken at home Schools Attended Does your child receive any special education services? Does your child have any allergies? Reason for Applying Why are you considering Golden Academy?0 / Family Information Father’s Information Father’s First Name Father’s Middle Name Father’s Last Name Home Address City State Zip Cell Phone Email Addressemail Occupation Employer Business Phone Business Address Highest Degree earned Synagogue Affiliation Community Activities and Positions Held Marital Status Mother’s Information Mother’s First Name Mother’s Middle Name Mother’s Last Name Home Address City State Zip Cell Phone Email Addressemail Occupation Employer Business Phone Business Address Highest Degree earned Synagogue Affiliation Community Activities and Positions Held Marital Status Grandparents’ Information Father’s Side Grandfather’s Full Name Grandmother’s Full Name Home Address Mother’s Side Grandfather’s Full Name Grandmother’s Full Name Home Address Applicant’s Siblings Total Siblingspick one!Siblings012345 Name of First Sibling Age School Name of Second Sibling Age School Name of Third Sibling Age School Name of Fourth Sibling Age School Name of Fifth Sibling Age School Past School or Camp Experience School/camp name Length of time attended Teacher’s phone number Teacher’s name Add Another ExperienceAdd Another ExperienceYesNo School/camp name Length of time attended Teacher’s name Teacher’s phone number Add Another ExperienceAdd Another ExperienceYesNo School/camp name Length of time attended Teacher’s name Teacher’s phone number Tell Us More Please tell us about your child (strengths, challenges, interests, personality, etc).0 / The $200 application fee is to be submitted through Venmo @goldenacademy. When submitting through Venmo please put your childs name in the memo. The application is not complete until we receive the application fee. Submit & Pay Fee keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft – WordPress form builder