Register Online for New Students

For Returning Students you can use the Quick and Easy Returning Student Form by clicking here

We are currently accepting application forms for the 2018-2019 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 call us on 818-268-9666.

Please note that one registration form per child is needed.

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

Student Profile 1
 
Name
Last
Hebrew Name
DOB
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Where?
Is the natural mother of the child Jewish? Yes No
Have there been any conversions or adoptions in the family? If Yes, please explain.
Student Profile 2
 
Name
Last
Hebrew Name
DOB
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Where?
Student Profile 3
 
Name
Last
Hebrew Name
DOB
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Where?
Parent Information
 
Father's Name
Phone
Mother's Name
Phone
Address
City
State
Zip
Mother's Email Address
Father's Email Address
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.



Payment Information - $800 Annual Tuition  - Book and Registration Fee $60 - Security Fee $50

 2 Payment options:

1) 8 payments of $100 

2) Pay in full and receive a $20 discount

My contact information has not changed I would like to join Partnership/ Membership and get 1 month FREE!

Option 1:

Please charge my card now for
1 Child: $210 now, ($110 for Book, Registration and Security Fee $100 for first of 8 payments)
2 Children: $420 ($220 for Book, Registration and Security Fee $200 for first of 8 payments. You will receive $70 off of your last payment for the sibling discount)
3 Children: $630 ($110 for Book, Registration and Security Fee $100 for first of 8 payments.  You will receive $105 off of your last payment for the sibling discount)

After this payment We will charge the same card $100 per child for 7 consecutive months 

Option 2:

I will Pay in Full
1 Child: $890 One Payment
2 Children: $1,710 One Payment (Includes $40 payment in full discount and $70 sibling discount)
3 Children: $2,565 One Payment (Includes $60 payment in full discount and $105 sibling discount)

 
Please charge the card I have on File  
Please use the Following Credit Card Total Amount to be charged today
Name on Card CC #
Exp Date CVV Code
Address Zip


*“There is a one time payment of $60 for the book fee and registration fee and a security fee of $50 that is calculated into the first months tuition as seen above”

** There is a ($35) sibling discount per child that will be deducted from your final payment

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School 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, Chabad 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 Chabad Hebrew School activities and that these pictures may be used for marketing purposes.

If for any reason you decide to cancel during the year, you will be refunded from the beginning of the next month.

There are no refunds after May 1st and your card will continue to be charged until you complete all your payments.

 

 

I Accept

Name:
Initials:

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