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Request Information

Thank you for your interest in Mazel Day School! 

Please fill out the Inquiry form below and our Admissions Office will contact you to walk you through the admissions process and answer any questions you may have.

 

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Work Phone
    (Ex: 999-999-9999)
  • Cell Phone *
    (Ex: 999-999-9999)
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Work Phone
    (Ex: 999-999-9999)
  • Cell Phone *
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone
    (Ex: 999-999-9999)
  • How Did You Hear About Us? *
    Details:
  • Would you like a Tour of our school?

    * Yes   No
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Email Address
    Confirm Email Address
  • Grade Level of Interest *
    School Year *
  • Does your child have an IEP or receive any special services?

    * Yes   No
  • Is your child currently attending a different school?

    * Yes   No
  • What are some of the reasons that you are interested in Mazel Day School?

    *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •