Quick and Easy Registration for Returning Students

Quick and Easy Registration for Returning Students

Hebrew School 2023/24- 5784

(Do you know of a new family looking for a Hebrew School? Refer them to Chabad and receive a $100 tuition credit)

*Registration received before May 22nd receive automatic 5% discount. Registrations received after August 1st incur a late fee of $75
Number of Returning Children Being Registered*
Children's Information:
Child 1:*

First Name Last Name
Grade Entering as of Sept. 2023:*
Birth Date*

Month Day Year
Tuition: * Plan A: Pay in Full Plan B: Pay in Installments
To view and fill out the Chai Club partnership form, click here.
Does your child have an IEP? If yes, please email it in.*

YesNo
Track Selection: (choosing this track does not bind you for the entire year. You can choose a different track if your comfort level changes)

In PersonVirtualPods (create your own - 5 or more children, parents are responsible to form their own pods of similar ages)
Allergies: If any, please list.
Child 2:

First Name Last Name
Grade Entering as of Sept. 2023:
Birth Date

Month Day Year
Does your child have an IEP? If yes, please email it in.

YesNo
Child 2 Track Selection: (choosing this track does not bind you for the entire year. You can choose a different track if your comfort level changes)

In PersonVirtualPods (create your own - 5 or more children, parents are responsible to form their own pods of similar ages)
Allergies: If any, please list.
Tuition: Plan A: Pay in Full Plan B: Pay in Installments
Child 3:

First Name Last Name
Grade Entering as of Sept. 2023:
Birth Date

Month Day Year
Does your child have an IEP? If yes, please email it in.

YesNo
Child 3 Track Selection: (choosing this track does not bind you for the entire year. You can choose a different track if your comfort level changes)

In PersonVirtualPods (create your own - 5 or more children, parents are responsible to form their own pods of similar ages)
Allergies: If any, please list.
Tuition: Plan A: Pay in Full Plan B: Pay in Installments
I would like to contribute towards the scholarship fund for children who cannot afford full tuition:

$36$72$180$400
I would like to sponsor the education of another child for $1591
Payment Information:
Parent 1 Name:*

First Name Last Name
E-mail*

Address*

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

Parent 2 Name:

First Name Last Name
E-mail
Address is:

Same as above.Different.

Address

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

Was the students maternal grandmother born Jewish?*

YesNoOther
Was the students paternal grandmother born Jewish?*

YesNoOther
Please indicate any changes to your personal/contact information that has changed since last year:
Late Fee

$75
Total:

$75.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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Children's Information:

Payment Information:

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