Application

Nursery School Application

Thank you for choosing to register your child at Riverdale Temple Nursery School. We understand the importance of your child’s early education, and we recognize that you are entrusting your child to us to provide the highest quality early childhood education. We look forward to being your partner in your child’s development.
Child's Name*
Date of birth*
What age are you registering for?*
Please select all that you are interested in for your child.*
- Two’s 3 days 8:25am-1:00pm
- Two's 5 days 8:25am-1:00pm
- Three’s 5 days (3K) 8:30am- 2:45pm
- Four’s 5 Days (UPK) 8:45am-3:00pm
- 3's Early Drop Off 8:00am-8:30am
- 4's Early Drop Off 8:00am-8:45am
- 2's Extended Day 1/1:15pm-3:00pm
- 3's Extended Day 2:45pm-5:00pm
- 4's Extended Day 3:00pm-5:00pm
Gender*
Temple Member
Address, Apt Number, Zip Code*
Phone*
Parent/Guardian #1 First & Last Name*
Occupation
Daytime Phone*
Email*
Parent/Guardian #2 First & Last Name*
Occupation
Daytime Phone*
Email*
Does your child have siblings? Yes, No (Names, ages)
Please list siblings who have attended RTNS and years attended
Has your child had previous nursery school experience? Where?
What special talents/special needs/learning challenges does your child have:
Has your child been evaluated for any special needs?
What were the results, including any medication prescribed?
What would you like us to know about your child that will help us to make this a happy and fulfilling school experience? (Please use back of this sheet if you need more room)
Please tell us how you heard about our program?
Do you have any special talents to help our school?
Does your child have any allergies? If so, please list them below.*
Signatures: In order for us to process your application, please go to our website, and pay the non refundable application fee of $150. (Please sign your name and date)*

All payments can be made on the Nursery School Payments page under Nursery school tuition. In the notes please include your child's name and write "application fee".

	administrator@riverdaletemple.org
	P: (718) 548-3800 F: (718) 543-1492
	4545 Independence Avenue Bronx, New York 10471