Hebrew School Registration Form
If you're child is a returning student please fill out our quick and easy registration form
Part I: Student’s Information
Zip Code: Phone:
Part II: Parents’ Information
Father’s Full Name:
Mother’s Full Name:
Home phone: Home Fax:
Work phone (Father): Cell (Father):
Work phone (Mother): Cell (Mother):
Part III: Family
Part V: Hebrew Education
Father’s Hebrew Name:
Mother’s Hebrew Name:
Student’s Hebrew Name:
Does your child have any learning difficulties with general studies?
If yes, please describe:
Is the natural mother of the child Jewish? Yes No
Where there any conversions or adoptions in the family? Yes No
If yes, who?
Part VI: Medical Information
Is there any medical or other information (allergies, etc.) regarding your child that our school should be aware of?
Part VII: Payment Information
Please check your choice for method of payment:
(K-7th grade): Sunday 10-12:30pm
$850 per year (paid in full)
$425 (2 payments)
$142 (6 payments)
$1200 per year (paid in full)
$600 (2 payments)
$200 (6 payments)
There is a $50 registration fee ($25.00 off if submitted by Sunday May 21st) per child and a $30 book fee per child.
Family Discount: 10% off each additional child.
There will be a 3% ‘bank charge’ when using your credit card
Plan A: I am paying the entire amount now, which entitles me to a $30 discount off regular tuition.
Plan B: Please automatically charge my credit card at the beginning at each month
Plan C: I will pay 10 post dated checks for the beginning of each month, dated September through June. All checks must be submitted by the 1st day of Hebrew School.
(3% charge will be applied to all credit card transactions)
This page uses 128 bit SSL encryption to keep your data secure.