Register Online - New Students

HEBREW SCHOOL REGISTRATION FOR NEW STUDENTS
Please note: Application forms are to be filled out only AFTER a Hebrew School tour and family meeting with Sara
Child 1
Child's Name*
First NameLast Name
Hebrew Name*
Birth Date*
MonthDayYear
Grade entering - September*
Child 2
Child's Name
First NameLast Name
Hebrew Name
Birth Date
MonthDayYear
Grade entering - September
Child 3
Child's Name
First NameLast Name
Hebrew Name
Birth Date
MonthDayYear
Grade entering - September
Additional Information
Any there any conversions or adoptions in the family, (please provide details)
Any considerations, such as learning disorder or difficulty, the teacher should be aware of? (Confidential)
Does your child have any allergies or other medical conditions we should be aware of? If yes, please describe them and indicate special precautions or care needed.
What are your child’s special interests, likes or dislikes?
How does your child learn best?
Emergency Contact
First NameLast Name
Cell Phone
Area CodePhone Number
Parent's Information
Mother's Name
First NameLast Name
Hebrew Name
Mother's Birth Date
MonthDayYear
Mother's Occupation

Address*

Address (if different)

Phone Number (if different)
Area CodePhone Number
Father's E-mail*
Father Cell*
Area CodePhone Number
Father's Work Number
Area CodePhone Number
Marital status:
MarriedDivorcedSingleWidowed
Additional notable Information
Tuition
Tuesdays 4:00-5:45 PM
K - 1 grade $999
2nd - 4th grade $1,250
5th - 7th grade $1,450
$180 Security Fee per family
Please check off one of the tuition options:
1 Installment of full tuition2 installments; one in April for 50% and another on September 1st for 50%My family requests a scholarship. Please contact Sara to discuss.
Payment
(Please note: Payments via credit card will be charged a 3% transaction fee)
Total Amount
$

Payment

Credit Card Check

Postal / Zip Code

Country

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HEBREW SCHOOL REGISTRATION FOR NEW STUDENTS