*Mother's First Name: 

*Mother's Last Name:

*Mother's Email Address: 

*Mother's Phone Number:   

*Father's First Name: 

*Father's Last Name: 

*Father's E-mail Address:  

*Father's Phone Number: 

Check if there are any adoptions in the family: 

Check if there are any conversions in the family:  

If you have checked one of the boxes above, please list the person(s) adopted or converted, the date, the city, and the presiding Rabbi if applicable:  

*Child's Name:   

*Date of Birth:  
 

*Current School:  
 

*Current Grade Level: No School Experience Daycare Early Childhood 18 months Early Childhood 2 years old Early Childhood 3 years old Pre-Kindergarten Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade    

*Check if you live in Houston: 

*Check if you plan to move to Houston: 

*When would you like your child to begin attending Torah Day School?  

Comments or Questions: 

Thank you!  You will hear from us within three school days.