Register

Student Information
Please complete a separate form for each child you are registering.
Number of Children Registering:*
Child's Name*

First Name Last Name
Male/Female*

MaleFemale
Birth Date*

Month Day Year
Hebrew Name*
Grade Entering* Fall of 2024
School Attending*
Hebrew Reading*
Previous Jewish Ed.* Describe Jewish Education to date
Educational Learning Style * Is there anything that you can share with us about your child that will help us provide for his/her educational needs
Child 2: Name*

First Name Last Name
Child 2: Male/Female*

MaleFemale
Child 2: Birth Date*

Month Day Year
Child 2: Hebrew Name*
Child 2: Grade Entering* Fall of 2024
Child 2: School Attending*
Child 2: Hebrew Reading*
Child 2: Previous Jewish Ed.* Describe Jewish Education to date
Child 2: Educational Learning Style* Is there anything that you can share with us about your child that will help us provide for his/her educational needs
Child 3 Name:*

First Name Last Name
Child 3: Male/Female*

MaleFemale
Child 3: Birth Date*

Month Day Year
Child 3: Hebrew Name*
Child 3: Grade Entering* Fall of 2024
Child 3: School Attending*
Child 3: Hebrew Reading*
Child 3: Previous Jewish Ed.* Describe Jewish Education to date
Child 3: Educational Learning Style* Is there anything that you can share with us about your child that will help us provide for his/her educational needs
Family Information
Mother's Name*

First Name Last Name
Mother' s Hebrew Name

Home Address* If parents live separately, please use this field for Mother's Address. Complete Father's address below

Mother's Email*
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Home Phone

Area Code Phone Number
Mother's Cell*

Area Code Phone Number
Mother's Work

Area Code Phone Number
Father's Name*
Father's E-mail*
Father's Cell

Area Code Phone Number
Father's Work

Area Code Phone Number

Address - If Different than Mother's

Was the Student Born Jewish?*
Were the Student's Natural Parent's Born Jewish?*
Were the Student's Maternal Grandparent Born Jewish?*
Were the Student's Paternal Grandparent Born Jewish?
If you answered 'NO' to any of these questions please explain:
Permissions:

I authorize Chabad Hebrew School to take pictures/video of my child and use them for publicity purposes (i.e., Brochures, Websites)
Payment Information
Tuition: $700
Sibling Discounted Tuition: $675
Minimum Today: $100 (non-refundable)
Paying at this time:* Minimum payment with registration is $100. Balance is due on First Day of Hebrew School. Payment arrangements available.

Registering 1 Child $700Registering 2 Children $675 + $675Registering 3 Children $675 + $675 + $675Registering 1 Child - Deposit OnlyRegistering 2 Children - Deposit OnlyRegistering 3 Children- Deposit Only
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Total

$0.00

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Postal / Zip Code

Country

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Educate Your Child... Educate a Generation

Student Information