Hebrew School Registration

Please complete the questions below to the best of your ability.

If you have any questions or concerns you'd like to discuss with us, please contact us.

Hebrew School ages 5-13, Sundays 9.30 am-11.30 am. The School Calendar will emailed with completed registration. Orientation Family Breakfast will be Sunday September 6th 9.30 am.

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

Family Name*

Student 1 *

First Name Last Name

Hebrew Name

Birth Date*

Month Day Year

MaleFemale

Age*

Entering Grade:*

What school does your child attend?*

Describe Basic Hebrew Knowledge: (previous Hebrew School education, Hebrew reading, holidays)

Does your child have any learning difficulties with general studies? Explain*

Is there anything you want us to know about our child that would help us to help him/her?*

Student 2*

First Name Last Name

Hebrew Name

Birth Date*

Month Day Year

Age*

Entering Grade:*

MaleFemale

What school does your child attend?

Describe Basic Hebrew Knowledge: (previous Hebrew School education, Hebrew reading, holidays)

Does your child have any learning difficulties with general studies? Explain*

Is there anything you want us to know about our child that would help us to help him/her?*

Address*

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

Mother's Name*

First Name Last Name

Mother's Hebrew Name:*

Mother's E-mail*

I would like to receive news and updates by email

Mothers Phone Number*

Father's Name*

First Name Last Name

Father's Hebrew Name:

Father's E-mail*

Father's Phone Number*

Is the child's natural mother Jewish?*

YesNo

Are there any conversions or adoptions in the family history (including any maternal ancestors)? Please list name and family position of converted or adopted family member. These questions enable us to better serve our constituents. All information will remain confidential. *

Please list Bet Din (court of Jewish Law) and Rabbinic Authority involved in conversion or adoption:*

Synagogue Affiliation

Does either parent have any special resources or skills to offer our children or teachers? Details*

I would like to be involved with :

We offer Hebrew Enrichment on Wednesday afternoons.

Yes, I’m interested in signing up for Hebrew Enrichment on WednesdaysNo, I am not interested in additional classes

Yearly Tuition is $750.00 (includes $50 Registration Fee).

Discounts Available:

EARLY BIRD DISCOUNT: $50 Registration fee is waived off first child if registering before August 1 with registration deposit.

7% discount for upfront full payment.

Sibling discount: $50 Registration fee is waived off 2nd child's tuition.

Complete registration form and submit with registration deposit of first payment with credit card or zelle [email protected].

Mail checks to :

Chabad Hebrew School
7942 W Bell Road C5#101 Glendale, AZ 85308.

Tuition may be paid in full or in installments. Families may choose one of the following payment plans:

1. Full Payment: One-time payment

2. Two Installments (50/50): Two equal payments of 50% of total tuition.

3. Monthly Payment Plan: Tuition divided into monthly installments. All installment plans require a payment schedule to be arranged with the office prior to the school year. Payment is considered complete only when the full tuition balance is paid according to the agreed schedule.To set up your payment plan, please contact the office at 623.252.1759 or [email protected]

Payment*

Credit Card Zelle, Cash or Check

Postal / Zip Code

Country

Scholarship request. ** We will NEVER turn away a child for lack of funds. If you require a Scholarship, please call or email our office to request a scholarship form. Please fill out Scholarship Form Separately. Email [email protected] to request form.

I would like to request a scholarship formI do not need a scholarship form

payment plan options

Full Payment $7502 payments $325Monthly payments, $75/10 months. I will call office to set up a schedule.

Registration Deposit Child 1*

Registration Deposit Child 2

The Rabbi's Class: Post Bar Mitzvah Mentorship Program

$350

Total

$0.00

The following are authorized to take my child to and from school

In case of emergency, when neither parent can be reached, give names of two people who will take responsibility for your child.

Full Name

First Name Last Name

Phone Number

relationship to child

The following people may not pick up my child from school:

If parents cannot be reached and emergency medical advice is needed, permission is given to the school staff to phone child’s doctor:

Yes

Doctor and Doctor's Office & Phone number

Hospital Affiliation

In case of medical emergency requiring immediate emergency care, I authorize the paramedics to take my child/ren to the nearest hospital

Any Known Allergies? Any special medical condition.? Indicate Child 1 or Child 2. Please describe:

Medication child is taking on a regular basis. Indicate Child 1 or Child 2.

Parent Signature: fill in your name to sign as agreement

Month Day Year

at Hour Minutes

Hebrew School Registration:

Family Information

Parent Involvement & Volunteer Opportunity:

Financial

Emergency and Medical Information