TJC Registration

CHILD INFORMATION
Child Name*

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

Does Not Read Hebrew Recognizes Hebrew Letters Can Read Hebrew Slowly Can Read Hebrew Well
What else would you like us to know about your child?
Are the child's biological parents Jewish by birth*

Yes No
Comments
Have there been any conversions or adoptions in your family? **

Yes No
PARENT INFORMATION
Mother Name*

First Name Last Name
Father Name*

First Name Last Name
Mother Email*
Father Email*

Address*

Mother Cell Number*

Area Code Phone Number
Father Cell Number*

Area Code Phone Number
EMERGENCY INFORMATION
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationahip*
Pediatrician**

First Name Last Name
PAYMENT INFORMATION
Tuition $250 per 8 week session

To be paid by CC upon registration.

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
Sessions (Gr 4-7) $250/Session

Session 1 (Jan 4 - Feb 22 2023) Session 2 (Mar 1 - May 10 2023)
Tuition $65 for two meetings per session

To be paid by CC upon registration.

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
Sessions (Gr K-3) $125/Session

Session 1 (2 meetings, Jan - Feb 2023) Session 2 (2 meetings, Mar - May 2023)

Payment*

Credit Card Check

Postal / Zip Code

Country

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Educate Your Child... Educate a Generation

CHILD INFORMATION