Register Online

We are currently accepting application forms for the 2008-2009 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

Please note that one registration form per child is needed.

We look forward to a wonderful year of learning and growth. 
   

Student Profile
Name
Last
Hebrew Name
DOB	Month Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sept. Oct. Nov.     Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    Year 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
School
Grade Entering	Grade Entering Kindergarten First Second Third Fourth Fifth Sixth Seventh
Hebrew Reading Proficiency	None    Somewhat    Well
Previous Jewish Education	Yes            No
Where?

Parent Information
Father's Name
Phone
Mother's Name
Phone
Address
City
State
Zip
Email Address

Synagogue affiliated with: 
Is the natural mother of the child Jewish? Yes No
Were there any conversions or adoptions in your family? Yes No
If yes, please describe:

Chabad Hebrew School Tuition Agreement

The following is a tuition agreement for the Chabad Hebrew School. The agreement explains the tuition fees, payments plans and refund policies. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes.

The tuition for the Chabad Hebrew School is $500.00 per year per child (this includes a registration & book fee).

Discounts: There is a 10% discount off of the regular tuition for each additional child of the same family. There is a 10% additional discount off your total tuition for each child of another family you successfully introduce to the Chabad Hebrew School.

You may choose from the following payment methods:
PLAN A: You may pay the entire amount in full with a check, cash or credit card.

PLAN B: You may pay the annual tuition on a monthly basis by submitting 10 checks of $50.00 each, dated August through May. All checks must be submitted before the first day of Hebrew School.

PLAN C: You may use your credit card to pay the tuition on a monthly basis.  Your credit card will be billed $50.00 monthly August through May.  To do so please include your credit card number information in the pay online tab.

 

Emergency Information
Emergency Contact 1
Phone
Emergency Contact 2
Phone

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of?  If yes, please describe them and indicate special precautions or care needed. 

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept   

Name:     Initials:

We look forward to a wonderful year of learning and growth!