Student Information
First Name*
Last Name*

Birthdate (mm/dd/yyyy)*

Grade 2025-2026*

Home Address *

City *
State*
Zip Code *

Phone Number

Year applying for:

Father
Father Title (please select one)*
Father First Name*
Father Last Name*

Home Address (if different from above)
Father Cell Phone*
Father Email*

Mother
Mother Title (please select one)*
Mother First Name*
Mother Last Name*

Home Address (if different than above)

Home Telephone (if different than above)
Mother Cell Phone*
Mother Email*

Family Information
Marital Status*
Child/ren live(s) with*
Name of Shul and Rabbi*

Inquiry
Tell us about your child: *

Why do you think Tashbar would be a good school for your son? *

Please list previous schools attended:*