Online Application Form

Admissions Form

Application for Admission

Contra Costa Jewish Day School

Kindly mail a recent photo of your child and a $50 non-refundable application fee to CCJDS :

955 Risa Road
Lafayette, CA 94549

Please complete this form:
  • Student's Name First Last
  • Hebrew Name
  • Preferred or nickname
  • Date of Birth MM / DD / YYYY
  • City of Birth
  • Grade Applying for
  • Male/Female
  • Parent/Guardian 1:

  • Name  First Last
  • Cell Number - -
  • Home Number - -
  • Work Number - -
  • Email
  • Home Address (Parent 1)
    Street Address
    Address Line 2
    City
    State / Province / Region
    Postal / Zip Code
    Country
  • Occupation/Employer
  • Parent/Guardian 2:

  • Name  First Last
  • Cell Number - -
  • Home Number - -
  • Work Number - -
  • Email
  • Occupation/Employer
  • Home Address (Parent 2 if different)
    Street Address
    Address Line 2
    City
    State / Province / Region
    Postal / Zip Code
    Country
  • Child's living situation
  • If other, please explain:
  • Preferred numbers to call:
    Parent 1 Cell Parent 2 Cell Parent 1 Home Parent 2 Home
Parent 1 Work Parent 2 Work
  • Best time to call:
  • Name of Sibling #1 First Last
  • Date of Birth: MM / DD / YYYY
  • Grade/School Attending:
  • Name of Sibling #2 First Last
  • Date of Birth: MM / DD / YYYY
  • Sibling #2 -Grade/School Attending:
  • Please list additional siblings and date of birth:
  • School History (Please list all schools including preschools and years attended):
  • Please describe your child and let us know of any special strengths and/or challenges:

  • Does your child have any physical, educational, or psychological needs which may require accommodation? If so, please describe:

  • Why are you considering the Contra Costa Jewish Day School for your child's education?
  • How did you hear about the Contra Costa Jewish Day School?
    Web Search Information Meeting Word of Mouth From your preschool Other
  • Are you affiliated with a congregation? If so, please indicate:
  • I confirm that the information provided to CCJDS concerning my child for the admissions process is accurate:
    Yes

 



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