*Last Name
*First Name
*Hebrew Name
*Gender Male Female
*Date of Birth
*Address
*City
*Province
*Postal Code
*Country
*Home Phone
*Current School
*If we are full at this location, would you consider our Cortleigh Location?
*Physician Name
*Physician Phone
Insurance
*Ohip Number
*Allergies
Medical Note
*Title --Select Title-- Dr. Mr.
*Work Phone
*Cell Phone
*Email
*Title --Select Title-- Dr. Mrs. Ms.
Work Phone
*Marital Status --Select -- Married Divorced Separated Widow(er)
*Affiliation --Select -- Adath Israel Agudah South Armour Heights Jewish Centre Beth David Beth Emeth Beth Haminyan Beth Lida Beth Radom Beth Sholom Beth Tikvah Beth Torah Beth Tzedec Chabad Bayview Chabad Flamingo Chabad Markham Chabad of Midtown Clanton Park Darchei Noam Forest Hill Jewish Centre Habonim Holy Blossom Kehillat Shaarei Torah Khal Toras Chessed Kollel Ohalei Yom Tov Ledbury Jewish Centre Lodzer Cong. Magen David Marlee Shul Mishkan Avraham None Ohr Chaim Oraynu Cong. Other Petah Tikvah Sephardic Kehila Centre Shaarei Shomayim Shaarei Tefilah Shaarei-Beth El Shomrai Shabbos Song Shul Stashover-Slipia Temple Emanuel Temple Har Zion Temple Sinai Toras Emeth - Viewmount Toronto Partnership Minyan Uptown Chabad Village Shul Yorkville Jewish Centre Zichron Shneur
Have there been adoptions or conversions in the family?
If yes, please explain
Name Phone # Relation
*Emergency 1
*Emergency 2
Emergency 3
*Tuition --Select-- Annual Tuition
Total Amount:
These fees will only be charged upon acceptance of your child
Upon acceptance, a $1000 non-refundable and non-transferable payment will be charged.
For credit card payments, a 3% fee will be added. Etransfer can be sent to info@chabadavenue.com
*Card Type --Card Type-- Visa MC
*Card Number
*Expiration Date --Month-- 01 02 03 04 05 06 07 08 09 10 11 12 --Year-- 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037
*Security Code
Use Information above
*Name on Card
*Billing Address
*Billing Postal Code
Upon acceptance of your child, a non-refundable deposit will be charged to your credit card. This deposit goes toward tuition. Once your child is accepted into the program we require post dated cheques mailed or dropped off or you can opt to pay by credit card which will be charged as per the payment plan (3% credit card processing fee applies.) Please see the Tuition Schedule for the payment plan. Please note that there are no tuition credits or make up days for illness, holidays or family vacations. We require a one-month notice in writing if it becomes necessary to withdraw your child from the preschool. At that point your remaining post-dated cheques will be returned to you or we will cease to charge your credit card. The deposit and all fees paid are Non-Refundable and Non-Transferable, no exceptions. Please click the box to acknowledge that you accept the terms and conditions of our Payment and Refund policy. We will be contacting you via SMS occasionally.
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