Getting to know your student - Form

Last Name

Jewish learning is a lifelong experience. At B'nai Amoona, we want to stay in touch with our families about programming throughout the year, Whether you attend Day School or another learning institution; please fill out our forms so that we can send you information specific to your choices. We invite our entire community to participate in programming geared towards students from ages PreK through 12 grade.

If you have any questions, please contact Liessa Alperin, our Director of Innovative Learning and Engagement at Liessa@bnaiamoona.com

Student Information

* Student's First Name

* Student's Last Name

* Please call me (nickname)

* Date of Birth

* Gender

* 2018/2019 Grade Level

Student's Email

Student's Cell

* T-Shirt Size

Student's Secular School Name

Educational Information

We want your students to feel supported and successful at B’nai Amoona. We cannot do this without your partnership. Although they may only spend a few hours a week with us here at MKLC; we want to be a place they feel cared for and “seen”. Each of us has things that make us unique. Each of us has something that bothers us. Each of us has “best ways” for us to learn and grow. Please help me get to know your student and family so we can create, together, a place of laughter, learning, and love for your family.

Please choose what best describes your student. Some questions may have more than one answer .

* Learns best by:

Seeing DoingHearingWriting

* Tends to be more:

Please Select OneOutgoingReserved

* Tends to (_______) going to Religious School

Please Select OneLikeDislike

* My student tends to:

Please Select OneEnjoy making new friendsHang out with the same students at all timesFeel like they have lots of friends at MKLCFeel like they know nobody at MKLC

Other

Just like in “regular” school, we want to support your student in their specialized needs. We can only do this if we are able to partner with you and have the information we need to create the best program for them.

Please share with us some of your student’s greatest strengths and areas in which they are most proud. This may include: being social and friendly comes easy to them, they love learning about new things, they are great at sports, they are involved in theatre, they are very easy going.

Please take a few minutes to share with us any information about your student that may affect their ability to feel and be successful while here. Some topics may include: learning challenges, social needs, behavioral concerns, medical issues that may affect their ability to feel well when they are here, emotional needs or concerns that may affect their ability to feel comfortable.

Please describe any specific learning or behavior challenges that your student may have OR medical situations that we should be aware of so that we may provide the best experiences during Religious School for your student.

Does your student have an IEP (Individualized Education Plan ) or 504 plan

*If you choose “yes,” we will call to discuss this with you further. You may email a copy of your child’s IEP or 504 plan to Liessa Alperin at Liessa@bnaiamoona.com. This will be kept confidential, but be used to create the best learning plan for your students.

Allergies & Additional Information

Does your student have any food allergies?

If you answered YES we will be sending you a FOOD ALLERGY ACTION PLAN to fill out.

Please specify

Does your student have any other allergies that we should be aware of to create a safe environment for them to learn?

Does your student have any other medical needs that you feel comfortable sharing with us?

Does your student take any medications?

Please specify

Will they be taking medications/ or be on these medications during school hours:

Please specify

Please include in the space below any additional information that you would like us to share with your student’s teacher.