Hebrew School Registration

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
MaleFemaleOption 3
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:
MaleFemaleOption 3
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?
Family Information

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?

YesNoOption 3
Are there any conversions or adoptions in the family history (including any maternal ancestors)? These questions enable us to better serve our constituents. All information will remain confidential. Please list name and family position of converted or adopted family member.
Please list Bet Din (court of Jewish Law) and Rabbinic Authority involved in conversion or adoption:
Synagogue Affiliation
Parent Involvement & Volunteer Opportunity:
Does either parent have any special resources or skills to offer our children or teachers? Details
I would like to be involved with :

Tu Bshvat PicnicPhotographyHosting Parents Night OutHosting the Havdala Bonfire & Pajama PartyChaperoning Field TripsSpecial School Event Set Up or CleanupSpecial School Event Supply ShoppingPurim Gift Basket DriveSilent Auction
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 classesOption 3
Financial
Double-click to edit this text...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.

10% 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 via credit card online at www.ichabad.org/donate or zelle [email protected].

Mail checks to :

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

Credit Card Payments may be made online. Call into office to do automatic deposit on personal schedule or submit credit card info below. Make sure to note in memo that this payment is for Hebrew School Tuition.

Payment*

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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 formOption 3
Registration Deposit

$50$75$100
Total

$0.00
Emergency and Medical Information
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:

YesOption 2Option 3
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 to the nearest hospital
Any Known Allergies? Any special medical condition.? Please describe:
Medication child is taking on a regular basis
Parent Signature: fill in your name to sign as agreement
Month Day Year
at Hour Minutes
Should be Empty:

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Hebrew School Registration:

Family Information

Parent Involvement & Volunteer Opportunity:

Financial

Emergency and Medical Information