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Bnos Esther Malka
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Bnos Esther Malka
APPLICATION FOR ENROLLMENT 5787/2026-2027
Student
Last Name
First Name (spelled in English, how it should appear on all school projects, papers etc.)
Legal Name (as is written on birth certificate- Last, First)
Applying To Grade
--Select--
Primary
1
2
3
4
5
6
7
8
First Name (spelled in Hebrew, how it should appear on all school projects, papers etc.)
Last Name Spelled in Hebrew
Birth Date (English)
Birth Date (Hebrew)
Place of Birth
Citizenship
Previous School
Previous School/Camp
Kindergarten Morah Currently Attending '25-'26
Morah's Phone Number
School Currently Attending '25-'26
School Phone #
School Address
Principal's Name
Principal's Phone #
Morah Name
Morah's Phone Number
English Teacher Name
Teacher's Phone Number
If Applicable: Name of Daycare
Summer Day Camp July-August '25
Director's Name
Director's Name
Director's Phone #
Phone Number
Last Year's Morah '24-'25
Morah's Phone Number
Family Information
Parents' Marital Status
--Select--
Married
Widowed
Divorced
Student Lives With
--Select--
Father
Mother
Father
Home Phone Number (if no home phone please enter the household's main phone number)
Address
City
State
Zip
Mother
Home Phone Number (if no home phone please enter mother's cell)
Address
City
State
Zip
Father
Title
--Select--
Rabbi
Mr.
First Name
Cell Number
Email
Yeshiva Attended
Mesivta
Bais Medrash
Kollel
Which Years
Rosh Chaburah
Phone Number
Current Kollel
Shul Affiliation
Rav's Name
Rav's Phone Number
Work Information
Occupation
Work #
Name of Employer/Firm
Owner
Employee
Address
City
State
Zip
Mother
Title
--Select--
Mrs.
Rebbetzin
First Name
Maiden Name
Cell Number
Email
High School Attended
Post High School (Seminary)
Work Information
Occupation
Work #
Name of Employer/Firm
Owner
Employee
Address
City
State
Zip
Grandparents
Relationship
--Select--
Child's Paternal Grandparents
Child's Maternal Grandparents
Child's Paternal Grandfather
Child's Paternal Grandmother
Child's Maternal Grandfather
Child's Maternal Grandmother
Child's Paternal Great Grandparents
Child's Maternal Great Grandparents
Last Name
Grandfather's Title
--Select--
Rabbi
Mr.
Grandfather's Name
Deceased
His Cell
His Email
Grandmother's Title
--Select--
Mrs.
Rebbetzin
Grandmother's Name
Deceased
Her Cell
Her Email
Home Phone Number
Address
City
State
Zip
Relationship
--Select--
Child's Paternal Grandparents
Child's Maternal Grandparents
Child's Paternal Grandfather
Child's Paternal Grandmother
Child's Maternal Grandfather
Child's Maternal Grandmother
Child's Paternal Great Grandparents
Child's Maternal Great Grandparents
Last Name
Grandfather's Title
--Select--
Rabbi
Mr.
Grandfather's Name
Deceased
His Cell
His Email
Grandmother's Title
--Select--
Mrs.
Rebbetzin
Grandmother's Name
Deceased
Her Cell
Her Email
Home Phone Number
Address
City
State
Zip
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Emergency Contacts
Emergency contacts and phone numbers if parents cannot be reached:
Name
Phone Number
Relationship
Name
Phone Number
Relationship
Name of Family Physician
Physician's Phone Number
Please indicate if any activity is restricted for your child.
Please list any special services your child receives i.e. Speech, PT, OT, etc.
Does your child have an IEP?
Yes
No
Please upload a copy of your child's IEP
Choose file
Language spoken at home
Where did your child spend the last two summers?
This past summer
Last summer
If you were in a bungalow, specify where.
Who referred you to Bnos Esther Malka?
Siblings
First Name
DOB
Grade
School
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I agree to pay full tuition.
I am requesting a scholarship.
Note: Tuition does not include Building Fund, School Dinner, Lunch, Registration, or Trips.
I understand that all Bnos Esther Malka students must be immunized according to N.J. State Immunization Guidelines and up to date on all immunizations. Immunization records will be mandatory at the time of enrollment.
Confirmation
Click here for Bnos Esther Malka guidelines.
I have read and agree to follow the guidelines of the school.
Father's Signature
Date
Mother's Signature
Date
The entire application must be complete. An incomplete application will not be considered.
Bnos Esther Malka of Lakewood, NJ admits students of any race, religion, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at this school. It does not discriminate on the basis of race, religion, color, national or ethnic origin in administration of its educational policies, admission policies, scholarship and loan programs, and athletic and other school administered programs.
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