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2s Registration Form
NAME OF CHILD__________________________ SEX _____ BIRTHDATE:
AGE OF CHILD AS OF SEPTEMBER 2014 Years____________
Months______________
PARENT NAME:
BUSINESS PHONE:
PARENT NAME:
BUSINESS PHONE:
ADDRESS:
E-MAIL: _____________________________________________________________________
HOME PHONE: ____________________ ARE YOU A TEMPLE MEMBER? Yes [ ] No [ ]
After selecting your choice of program, please sign this form and enclose the required deposit. This
deposit will be applied to your childs tuition. Please make check payable to TSTI.
Mail to: Carol Paster, Iris Family Center, 432 Scotland Road, South Orange, New Jersey 07079.
Parent Signature:
Date: