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Register for 2016-17

Register for 2016-17

HS Banner 2016-17 Header.jpg

Welcome to another great year at the Hebrew School!

Please fill in the following information for the year 2016-17 / 5776-77:

Child's Name: Family Name:

Child's Jewish Name:

D.O.B. (mm/dd/yyyy):
Grade your child will be entering in 2016:

Mother's Name:

Is the Biological Mother of the Child Jewish? Yes No

Are there any conversions in the family? Yes No

If yes, please explain:

Father's Name:
Address:
City: State: Zip:
Email Address:
Contact Information:
Home Phone Number:
Mother's Cell:
Father's Cell:
In Case of Emergency:

Contact Name:

Relationship:
Phone Number:
Additional Child

Child's Name:

Child's Jewish Name:
D.O.B. (mm/dd/yyyy):
Grade your child will be entering in 2016:

REFER A FRIEND AND RECEIVE 10% OFF OF YOUR ANNUAL TUITION!
The annual tuition is $500.00 per child. There is a 5% discount for every additional child in the family. Please inform us if you will be needing assistance with this BEFORE the start of the school year.

Payment Information:
I would like to pay: In Full In 4 Installments (Oct., Dec., Jan., Apr.):
Amount:$
Credit Card Type
Name on Card
Billing Address
City Zip Code
Credit Card Number
Expiration Date: Month (MM) Year (YYYY)
Security Code on Card
 

 

 

Classes will resume after Summer Break in September 2016

Look forward to seeing you greeting you!

 

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Upcoming events
Jun. 22, 2017
Morning Services
Jun. 23, 2017
Morning Services
Jun. 25, 2017
Morning Services
Jun. 26, 2017
Morning Services