Hebrew School Registration 2020-2021

Child's first name

Child's Jewish name

Child's last name

Grade entering 2020

Gender

MaleFemale

Birth Date

MonthDayYear

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail

I would like to receive news and updates by email

Phone Number

Area CodePhone Number

I would like to register my child for (days & tuition):

Sunday Program from 9:30-12:00 - $1,250 plus $50 book and supply feeEnrichment Wednesdays 3:45-5:15 (Sun. & Wed. class) - $1,850 plus $50 book and supply fee. (please choose one even if requesting scholarship)Chabad Teen Club - Sundays 9:30-12:00 in New Rochelle (suggested donation $720 for year)Hebrew School for Adults- Sundays 9:30am-10:30amChabad Teen Club - Wednesdays 3:30-5:00 at 36 Garth Road in Scarsdale (suggested donation $720 for year)FREE KINDERGARTEN - for families new to Chabad Hebrew School)FREE HOLIDAY HEBREW SCHOOL SPECIAL PROMOTION- select payment by check and you will not be charged

Total

$0.00

General information:

Known Food Allergies - Please list all food allergies.

What is your current synagogue affiliation?

Have been there any adoptions or conversions in the family? Please explain.

Does your child have siblings? Please list all siblings, their age and school they attend.

What is your child's previous school, group or camp experience (if any)?

Does your child receive any special services? i.e.: Speech, OT, PT, SEIT, etc. Please be specific.ck to edit

Are there any special circumstances which we should know?

Parents' information:

Father

First name

Last name

Email

Occupation

Business phone

Cell phone

Mother

First name

Last name

Email

Occupation

Business phone

Cell phone

Payment information:

I will be paying by

CheckCC (5% surcharge)

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Questions & Answers

Alef Bet Preschool

Chabad Hebrew School

Friendship Circle

Chabad of Scarsdale

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