HS Registration - 2022/23 School Year

Sunday Mornings 9:15-11:45am
1st Child's Name*
First NameLast Name
1st Child's Hebrew Name*We can help give your child a Hebrew name
1st Child's Birth Date*
MonthDayYear
1st Child's School*
1st Child Grade entering*as of September 1, 2021
First Child's E-mail
2nd Child's Name
First NameLast Name
2nd Child's Hebrew NameWe can help give your child a Hebrew name
2nd Child's Birth Date
MonthDayYear
2nd Child's School
2nd Child Grade enteringas of September 1, 2021
2nd Child's E-mail
Additional notable InformationPlease let us know if there are any allergies or other important information we need to be aware of.
Parents Information
Mother's Name*
First NameLast Name
Mother's Hebrew Name
Mother Jewish by:*
BirthChoice
Mother's Cell*
Area CodePhone Number
Mother's Home or Work
Area CodePhone Number
Mother's E-mail*
Mother's Occupation
Father's Name*
First NameLast Name
Father's Cell*
Area CodePhone Number
Father's Home or Work
Area CodePhone Number
Father's E-mail*
Father's Occupation
Best way to send Hebrew School updates:*
Cell PhoneEmailHandout
I am willing to assist in school activities, please contact me

Address*

Emergency Contact Name*
Emergency Contact Relationship*
Emergency Contact Number*
Area CodePhone Number
Hebrew School 2022/23 Tuition Rates
Tuition Fee: $1,000
Additional Security Fee: $100
Promotional Tuition Rate of $950 until June 15
($50 refer-a-friend discount)
Payment Amount
$

Payment

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Parents Information