The Frederic G. and Lawrence G. Cohen Religious School
1251 Middle Road, East Greenwich, RI 02818 · (401) 885-6600
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Registration Form for Cohen Religious School
We are looking forward to welcoming you and your entire family to the 2013-2014 / 5774 school year at the Cohen Religious School. Please fill out the registration form below (or
download the printable version
) so that we can ensure an appropriate place for every child in our school.
Please note that your child's/children's place/s in school are only secured when the Torat Yisrael office is in receipt of a $150 deposit per student. (Temple Torat Yisrael, 1251 Middle Rd., East Greenwich, RI 02818, att'n: Sheryl Ponder).
Student #1 Information
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First
Last
Date of Birth
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Grade in School
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With whom does this child live?
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Please share with us information about special accomodations and/or special needs and/or allergies relevant to your child.
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Student #2 Information
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First
Last
Date of Birth
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Grade in School
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With whom does this child live?
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Please share with us information about special accomodations and/or special needs and/or allergies relevant to your child.
*
Student #3 Information
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First
Last
Date of Birth
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Grade in School
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With whom does this child live?
*
Please share with us information about special accomodations and/or special needs and/or allergies relevant to your child.
*
Student #4 Information
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First
Last
Date of Birth
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Grade in School
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With whom does this child live?
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Please share with us information about special accomodations and/or special needs and/or allergies relevant to your child.
*
Parent #1
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First
Last
Email
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Home Address
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Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
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Cell Phone Number
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Place of work (if relevant)
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Work Phone Number
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Parent #2
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First
Last
Email
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Home Address (omit if same as parent #1)
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Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number (omit if same as parent #1)
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Cell Phone Number
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Place of work (if relevant)
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Work Phone Number
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In Case of Emergency:
Name and relationship
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Name and relationship
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Phone Number
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Phone Number
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Submit