Application | Jews of East Village

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JoEV Afterschool

Application Form 2026-2027 School Year

Guardian Information

Parent/Guardian - One

*Parent First name

*Parent Last name

*Email

*Phone Number

Parent/Guardian - Two

First Name

Last Name

Email

Phone Number

*Religious Affiliation

Mom's Jewish

Dad's Jewish

Both Parents Jewish

Multi-line address

*Country/Region

*Address

*City

*Zip / Postal code

Child Information

*Child First name

*Child Last name

*Birthday

Month

Day

Year

*Grade attending

*School attending

*Does your child require School pick up?

*Who will be picking up your child from JoEV center?

*Any known allergies (incl. reactions to medications) and any present medical conditions?

We would love to get to know you & your child a bit more:

*Tell us about your Family.

*How did you hear about JoEV Afterschool

*Please upload a picture of your Child

*What would you LOVE for your child to gain at JoEV afterschool?

Which Days Will You Child Be Joining:

*Monday

Fall Semester

Spring Semester

*Wednesday

Fall Semester

Spring Semester

*Full Year: Monday & Wednesday

Yes

Tuition:

One Day:

Semester: Full Amount $1,200

Full Year: Full Amount $2,200

Two Days:

Semester: Full Amount $2,200

Full Year: Full Amount $4,000

Discount Special (Enter Custom Amount)

*Tuition:

$

Parent/Guardian Signature

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