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ב"ה

Hebrew School Registration

Number of Student/s
Student Information
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
School
Previous Jewish Education
Grade entering*
Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Student #2 Information
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
Grade entering*
Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Student #3 Information
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
Grade entering*
Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Parents Information
Father's Name*
First Name Last Name
Father's Cell

Area Code Phone Number
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother Jewish by:*

BirthConversion
Please upload a copy of conversion proof
Mother's Cell*

Area Code Phone Number
Best way to send Hebrew School updates:*

Cell PhoneEmailHandout
I am willing to assist in school activities, please contact me
Payment
Registration Fee

ƒ350.00 ($200) per studentOther
Number of Student/s
Other

Pay in 4 payments of ƒ87.50 ($50) per studentSubsidized Tuition
4 Payments of ƒ87.50 will be paid on the following dates:
- September 15, 2024
- December 15, 2024
- March 15, 2025
- June 15, 2025
We will never turn away a Jewish child due to lack of funds.
Total in US$

$0.00
Disclaimer: Florin to USD conversions are approximate.

Payment Method*

Credit Card Other

Postal / Zip Code

Country

Should be Empty:

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