Gan Shalom Cooperative Preschool

Gan Shalom Cooperative Preschool

118 10th Street NE * Washington DC 20002 *

Lisa Hix, President * Naomi Seck, Membership Chair * Mary F. Meyerson, Director/Teacher

** Enrollment Application 2013-2014 **

Gan Shalom, the Hill Havurah preschool, is a cooperative Jewish preschool organized and governed by parents. Classes are led by experienced teachers assisted by a rotating roster of parents and regular caregivers. Enrollment is open to Jewish and non-Jewish children who are 2 and 3 on September 1.

We currently offer a M-W-F and a T-Th class, with sessions from 9:00AM to 12:00PM. We are considering expanding the program in the coming year, depending on interest from prospective families.

Feel free to direct any questions to Naomi Seck at or Mary Meyerson at .

Please send your application, postmarked by February 25, 2013, and a $50 non-refundable application fee to:

Naomi Seck
107 15th Street SE
Washington, DC 20003

Child’s Name:______Date of birth:______

Gender: M F Jewish ties? ______

Language(s) at home: ______

Parent/Guardian #1:______E-Mail:______Address:______Phone:______Mobile:______

Work Address:______Phone:______

Parent/Guardian #2:______E-Mail:______Address:______Phone:______Mobile:______

Work Address:______Phone:______

Sibling's Name:______Age:______School:______Name:______Age:______School:______Name:______Age:______School:______

How did you learn about Gan Shalom? (Please “X” those that apply):
Friend/neighbor ____ MOTH listserv ____ Hill Havurah Web site ____ MOTH School Information Night ____ Local newspaper ____ Other ______

1. What is your preference for attendance? 2 3 4 5 days per week. (Circle one or more - if more than one, please explain preferences below.)

You may be offered a schedule other than your preference depending on the overall scheduling of the class.

2. Please describe any of your child's previous group experiences (play groups, day care, etc):

3. Please describe any special requirements (allergies, medications, physical needs, etc.) that will help us in assessing our ability to meet your child’s needs. Also, please indicate if there has been any discussion of an intervention for developmental reasons (speech therapy, motor development, etc.)

Please read before signing:

Gan Shalom depends on parent involvement. Each participating family will be expected to provide assistance in the classroom and provide snacks. Some also serve on the Executive Board or a committee or help with school programs or activities. Finally, parents are expected to attend occasional parent meetings. By submitting this application, you agree to share in these responsibilities if your child attends Gan Shalom.

Co-op duty may be performed by parents or regular caregivers. Each individual who will perform co-op duty must undergo a background check with fingerprints, submit a completed health form, and be proficient in English.

Gan Shalom aims to have Jewish students comprise at least 50% of each class. However, we encourage both Jewish and non-Jewish applicants to apply, and Gan Shalom has always had non-Jewish students. Siblings of Gan Shalom students and alumni will also be given preference. Gan Shalom Preschool does not discriminate based on ethnic, racial, economic, or other diversities among its membership.

Parent/Guardian #1 signature______Date______

Parent/Guardian #2 signature______Date______(optional)