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CHILD'S INFORMATION
Last Name
*
First Name
*
Age
*
Birth Date: dd/mm/yyyy
*
Hebrew Name (If Applicable)
Primary School
Please Select One
*
Male
Female
Home Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Email Address
*
Are there any important education or medical needs we should know about your child?
*
Is your child currently on any medication?
*
Describe child's previous Jewish education (if applicable)
*
PARENTS' INFORMATION
Father's Name
*
Father's Occupation
*
Father's Cell Phone
*
Father's E-mail
*
Father
*
Born Jewish
Not Jewish
Converted to Judaism
Mother's Name (Include Maiden Name)
*
Mother's Occupation
*
Mother's Cell Phone
*
Mother's E-mail
*
Mother
*
Born Jewish
Not Jewish
Converted to Judaism
TUITION INFORMATION
Tuition for the school year is $75/month, plus a $75 registration fee.
Hebrew School is in session: Sept. 8, 2024 - May 25, 2025
Please check the following boxes to indicate your consent.
*
The office will contact me to set up my tuition payment plan. For questions: (561) 544-2854.
I will pay the one-time, non-refundable $75 registration fee.
***I understand that final acceptance into the Hebrew School will be decided after an interview with the Hebrew School Director.***
Click Here to Pay the $75 Registration Fee
$75.00
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