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Hebrew School Registration

Hebrew School Registration


We are currently accepting application forms for the 2017-2018 school year. Please fill out all fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

At the bottom of the registration form please be sure to fill out the information needed for the $100 registration fee, which can be paid online through this secure form.

If you are registering more than one child, please fill out this form for each child.

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

Student Information
First Name   Last Name
Hebrew Name   D.O.B.
School   Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No If yes - where?


Parent Information
Father's Name   Father's Cell
Mother's Name   Mother's Cell
Address   City, State, Zip
City State Zip
Home Phone      

Father's Email Mom Email

Were there any conversions or adoptions in the family? Yes No

If yes, please explain:

Emergency Information
Emergency Contact 1   Phone
Emergency Contact 2   Phone


Confidential: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.



As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Hebrew School of the Arts to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Name:
Initials:

Payment Information

• Tuition for the coming year will be $900, which includes book and miscellaneous fees.

I understand that a $100 deposit ONLY, that will be applied towards tuition, will be charged to my credit card along with my form submission.

The remaining tuition balance can be paid by check, mailed to:

The Chai Center • 105 St. Paul Street• Brookline, MA 02446

Name on card   Card Type
Charge Amnt.   Card Number
Exp. Date   CVV Code 3 digits on back of card
Promo Code
     


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

 

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