Charter Student Admission Application
For: Eleanor Kolitz Hebrew Language Academy School Year 2023-2024 (current school year only)
                (Application for the 2024-2025 school year will be available on February 1, 2024.)

Using this electronic Google Form requires an email address. Print applications are available at our campus for your convenience. Your application choice does not affect eligibility
PLEASE READ: Boundaries- https://bit.ly/EKHLA_Boundaries 
                            Application Instructions: https://bit.ly/EKHLA_APP_Instructions 
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Email *
Student's Last Name (Apellido) *
Student's First Name (Primer Nombre) *
Middle Initial (Inicial del segundo nombre) *
Mark N/A if no middle initial. (Marque N / A si no tiene la inicial del segundo nombre.)
Date of Birth (Fecha de nacimiento) *
Kindergarten students applying for the current school year must have turned 5 years of age by September 1, 2023. 
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Gender(Género) *
Grade Applying for  (Grado que solicita): *
Student Identification Number (if known) or Last four (4) digits of Social Security Number (SSN).Número de identificación del estudiante (si se conoce) o Últimos cuatro dígitos del Número de Seguro Social)
Voluntary Question  (Información Voluntaria)
I have another child currently attending this charter school. (Tengo otro hijo que actualmente asiste a esta escuela charter) or  this is a child of a staff or board member.(o este es un hijo de un miembro del personal o de la junta) *
Voluntary Question  (Información Voluntaria)
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