PJ Elementary Interest Form

Filling out this form will ensure you never miss a PJ Elementary meet-up and give us some input as to your own family's interests. The line-up for 2021-2022 was chosen by a group of parents with the goal of having casual monthly gatherings with a focus on having fun while getting to meet families from all across Jewish Omaha.

Each program will have a separate registration; RSVP is helpful but not necessary... it just allows us to plan for supplies and know to keep an eye out for you. Feel free to spread the word.

Questions?
Abigail Kutler, 402-660-7519, aerpelding@gmail.com
Jennie Gates Beckman, 402-334-6445, jbeckman@jewishomaha.org

more about PJ Library in general: www.pjlibrary.org

Question Title

* 1. Adult #1

First Name

Last Name

ZIP/Postal Code

Email Address

Cell Phone

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* 2. Second Adult in the Household, If Any

First Name

Last Name

ZIP/Postal Code

Email Address

Cell Phone

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* 3. Child's information

First Name

Last Name

Date of birth (mm/dd/yyyy)

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* 4. 2nd Child's information, if applicable

First Name

Last Name

Date of birth (mm/dd/yyyy)

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* 5. 3rd Child's information, if applicable

First Name

Last Name

Date of birth (mm/dd/yyyy)

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* 6. 4th Child's information, if applicable

First Name

Last Name

Date of birth (mm/dd/yyyy)

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* 7. Where do your children attend school? Please check all that apply.

OPS

District 66

Millard

Elkhorn

Bennington

Private school (name in comment field)

Homeschool

Other (please specify below)

Provide clarification here for above answers:

PJ Elementary Interest Form

Question Title

* 1. Adult #1

Question Title

* 2. Second Adult in the Household, If Any

Question Title

* 3. Child's information

Question Title

* 4. 2nd Child's information, if applicable

Question Title

* 5. 3rd Child's information, if applicable

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* 6. 4th Child's information, if applicable

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* 7. Where do your children attend school? Please check all that apply.

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* 8. What does your family enjoy doing together?

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* 9. What are you looking forward to in the coming year?