New Student Application for Enrollment

Please complete the following application for each child. Each application must be accompanied by a $150 deposit, and applications are processed on a first-come, first-serve basis. Please contact Danna Cook, Director of Admissions, at danna.cook@addlestone.org with any questions.

Applicant's Name *

First

Last
Date of Birth *
Applying for Which Class *
Sex *
Home Address *
Parent/Legal Guardian #1
Name *

First

Last
Relationship to Student *
Home Address (if different)
Email Address *
Telephone Number *

###-###-####
Employer & Occupation *
Religious Affiliation *
Parent/Legal Guardian #2
Name

First

Last
Relationship to Student
Home Address (if different)
Email Address
Telephone Number

###-###-####
Employer & Occupation
Religious Affiliation
Are applicant's parents separated or divorce?
If yes, who has legal custody? With whom does applicant live and to whom should school documents be sent?
How did you hear about Addlestone Hebrew Academy?
Has applicant previously applied for admission to AHA?
If applicant has previously applied, when?
Current School & Current Grade, if applicable
Has applicant ever been suspended, expelled or withdrawn from school for any reason?
If applicant has special needs, please explain what accomodations would be needed to allow a fair evaluation for admission.
Has applicant ever undergone an educational evaluation administered by a psychologist, psychiatrist or counselor? If yes, please give date of consultation and submit copies of test results or consultation reports.
Have any educational/learning difficulties been identified? Has applicant been in a resource or tutoring program?
Please provide any additional information concerning the applicant about which the school should be aware (developmental, family life, medical concerns, etc.)
What three adjectives best describe your child? *
Please share with us why you feel AHA would be a desirable environment for your child and for your family. *
If any of the applicant's relatives are alumni of AHA/Charleston Hebrew Institute, please list their names and years attended.
In the applicant is in Early Childhood, please indicate the number of days and hours per week for which you are applying. Please note this is not a guarantee of availability.

Monday-Friday (required for EC-4) Monday, Wednesday, Friday Tuesday, Thursday (Tiny Tots, EC-2 Only)
AM Class Only (9 AM - 12 PM) AM and PM Class (9 AM- 3:25 PM M-Th, 3:00PM F) Tuesday, Thursday (Tiny Tots, EC-2 Only)
Would you like to receive information about AHA's tuition assistance program based on family need?
Parent Signature

New Student Application for Enrollment

Parent/Legal Guardian #1

Parent/Legal Guardian #2