Temple Isaiah
Religious School Registration Form
September 2017 – June 2018
Please fill out this form and return with your Religious School registration check made payable to: Temple Isaiah. Mail to: Temple Isaiah, 1404 Stony Brook Rd., Stony Brook NY 11790
Please Print
Please check which applies to you: □ Temple Member □ Non-Member (K-2 only)
Parent’s name (last name, first name):
Check if primary contact
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Jewish: Yes No
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Home phone:
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Address:
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Cell phone:
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E-mail address*:
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Signature:
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Phone during school hours:
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Does child live with both parents?
Yes No
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If no, are there custodial issues we should be aware of?
Yes No
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If yes, would you like us to contact you?
Yes No
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Parent’s name (last name, first name):
Check if primary contact
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Jewish: Yes No
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Home phone:
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Address:
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Cell phone:
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E-mail address*:
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Signature:
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Phone during school hours:
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Child’s name (last name, first name):
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Public school grade (Sept 2017):
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Child’s name (last name, first name):
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Public school grade (Sept 2017):
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Child’s name (last name, first name):
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Public school grade (Sept 2017):
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Child’s name (last name, first name):
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Public school grade (Sept 2017):
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Do any of your children have special learning needs?
Do any of your children have a public school I.E.P.?
Do any of your children require daily prescription medication?
If you answered yes to any of the above questions, please specify on the reverse side of this application.
* To preserve the environment and to reduce costs, email will be the primary form of communication for Religious School matters. Please set your junk mail/spam filters to allow emails from tischool@optonline.net and administrator@templeisaiahsb.org. Whenever possible, information will also be included on the Temple’s website at www.tisbny.org. Therefore, we encourage you to check your emails and the website regularly.