Beth El Preschool Application for Enrollment 2024-2025 School Year

Family Information

Parent/Guardian 1 First Name

Last Name

Pronouns

Street Address

City

State

Postal/Zip Code

Email Address

Cell Phone Number

Relationship to children in the household

Are you a single parent?

YesNo

2nd Parent/Guardian in Household

Parent/Guardian 2 First Name

Last Name

Pronouns

Street Address (if different from parent 1)

City

State/Province/Region

Postal/Zip Code

Email Address

Please use a different email address than Parent/Guardian 1 as using the same email address will cause database errors within your account.

Cell Phone Number

Relationship to children in the household

Are you currently a member of Congregation Beth El?

YesNo

Are any of your child(ren)’s grandparent members of Beth El?

YesNo

If yes, please list their names

Is anyone in your family a current staff member at Beth El?

YesNo

If yes, please list their names

Page 3

Application Fee - $75 per child

Please select the number of students you are applying for

Total Due

$

Please select your payment method:

Credit CardACH/Electronic CheckI will mail a check payable to "BEPS" to the Beth El Preschool

Check Payment

Please send a check payable to "BEPS" to Beth El Preschool, 8215 Old Georgetown Road, Bethesda, MD 20814.

Electronic Check (ACH) Payment

Bank Routing Number

Bank Account Number

Confirm Bank Account Number

Bank Account Type

Bank Name

Account Holder Name

Credit Card Payment

There is a 3% transaction fee for paying registration by credit card. There is no fee for paying by eCheck.

I understand and agree to the 3% transaction fee.

3% Fee Information

Fee

$

New Total

$

Credit Card Number

Verification Code

Card Expiration Month (MM)

Card Expiration Year (YYYY)

Use a different billing address?

Yes

No

Billing Street

Billing City

Billing State

Billing Zip Code

Signatures

Any child, regardless of gender, race, religion, color, national origin or disability, shall be eligible for enrollment in the school. All classes are subject to minimum enrollment. Applications received by the deadlines (as listed on the BEPS website) are considered and slated according to the Priority Order of Admissions as listed in the BEPS Parent Handbook. Ultimate determination of acceptance may be made at the discretion of the Director. After the application deadline, applications will be considered on a rolling admissions basis according to class space availability. I understand that my child's application will not be considered complete until the application fee is received.

I understand and accept the terms of this application. Please type your name to act as your signature.

Please click the "Submit" button only once.

Authnet_Hidden_Fields