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Registration & Rates

FIRST DAY OF HEBREW SCHOOL IS SUNDAY, SEPTEMBER 10TH 2023

We are currently accepting application forms for the 2023-2024 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, or would like to request a printable registration form please contact us.

We look forward to a wonderful year of learning and growth.
CHILD INFORMATION
Child Name *

First Name Last Name
Hebrew Name
Date of Birth *
Entering Grade*
My Child*

Does Not Read HebrewRecognizes Hebrew LettersCan Read Hebrew SlowlyCan Read Hebrew Well
What else would you like us to know about your child?
Are the child's biological parents Jewish by birth?*

MotherFatherBoth
Was the child's maternal grandmother born Jewish? *

YesNo
Have there been any conversions or adoptions in your family? **

YesNo
If yes, please explain:
PARENT INFORMATION
Mother Name*

First Name Last Name
Father Name*

First Name Last Name
Mother Email*
Father Email*

Address*

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

Mother Cell Number*

Area Code Phone Number
Father Cell Number*

Area Code Phone Number
I would like to receive news and updates by email
MEDICAL INFORMATION
Are there any medical, develomental or behavioral information regarding your child/ren that the school should be aware of?*
Does your child/ren receive behavioral support in his/her regular school? *

yesno
If yes, please explain:
Does your child take any medication regularly?*

yesno
Does your child have any allergies? *

yesno
If yes, please describe:
Does your child have an Epi-pen? *

yesno
EMERGENCY INFORMATION
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Pediatrician**

First Name Last Name
Pediatrician Phone number*
*

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 will try to communicate with me prior to such treatment or care. 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.
Signature *
PAYMENT INFORMATION
Registration Fee $75
Book Fee $75
Tuition $700
Security and Sanitation Fee $100

Registration fee, book fee to be paid by CC upon registration.

Payment plans are available

No one will be turned away for a lack of funds; Please contact the Hebrew School office for payment plans or scholarship requests 908-238-9002

Payment*

Credit Card Check

Postal / Zip Code

Country

Amount* Hebrew School Tuition $700 - Book and Reg. $150 - Security and Sanitation $100

$150$250$950
Total

$0.00
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CHILD INFORMATION

PARENT INFORMATION

MEDICAL INFORMATION

EMERGENCY INFORMATION

PAYMENT INFORMATION