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Hebrew School Registration:

For any questions or more information please call Shana Dechter at
917-972-7185 or email [email protected]

STUDENT INFORMATION
First Name   Last Name
Hebrew Name   D.O.B.
School   Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No If yes - where?
PARENT INFORMATION
Father's Name   Father's Cell
Mother's Name   Mother's Cell
Address   Mother Email
Home Phone   Father Email
 
 
EMERGENCY INFORMATION
Emergency Contact   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.



 
PAYMENT SCHEDULE & OPTIONS

Your form is not complete without a payment plan.

Tuition for school year 

Sunday Program

2nd Child

Members Rate

$700

$650

Standard Rate

$800

$750

These fees are ALL inclusive there will be NO OTHER CHARGES for building fund, supplies, snacks etc.

I Will be sending in payment by check to Chabad Hebrew School

Name on card   Card Type
Charge Amnt.   Card Number
Exp. Date   CVV Code 3 digits on back of card
(If necessary) Payment Schedule Explanation:   Any additional comments/notes

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