Chabad Hebrew School
Registration form · Please complete one profile per student
No. of Students registering
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1
2
3
Student Profile 1
Registration Type:
Full Name
Hebrew Name
Age
Date of Birth
Before Dark
After Sunset
School
Please enter any changes from previous year
Grade Entering
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Pre-K
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Hebrew Reading Proficiency
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None
Somewhat
Well
Previous Jewish Education
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Yes
No
Previous Jewish Education - Where?
Does your child have allergies?
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Yes
No
Please describe allergies
Does your child take medication regularly?
- Please Select -
Yes
No
Please outline medication
Does your child have an IEP?
- Please Select -
Yes
No
Please list the details of the IEP and any special services your child receives
Please list any special needs that may require special awareness from our staff
Student Profile 2
Registration Type:
Full Name
Hebrew Name
Age
Date of Birth
Before Dark
After Sunset
School
Please enter any changes from previous year
Grade Entering
- Please Select -
Pre-K
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Hebrew Reading Proficiency
- Please Select -
None
Somewhat
Well
Previous Jewish Education
- Please Select -
Yes
No
Previous Jewish Education - Where?
Does your child have allergies?
- Please Select -
Yes
No
Please describe allergies
Does your child take medication regularly?
- Please Select -
Yes
No
Please outline medication
Does your child have an IEP?
- Please Select -
Yes
No
Please list the details of the IEP and any special services your child receives
Please list any special needs that may require special awareness from our staff
Student Profile 3
Registration Type:
Full Name
Hebrew Name
Age
Date of Birth
Before Dark
After Sunset
School
Please enter any changes from previous year
Grade Entering
- Please Select -
Pre-K
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Hebrew Reading Proficiency
- Please Select -
None
Somewhat
Well
Previous Jewish Education
- Please Select -
Yes
No
Previous Jewish Education - Where?
Does your child have allergies?
- Please Select -
Yes
No
Please describe allergies
Does your child take medication regularly?
- Please Select -
Yes
No
Please outline medication
Does your child have an IEP?
- Please Select -
Yes
No
Please list the details of the IEP and any special services your child receives
Please list any special needs that may require special awareness from our staff
Parent Information
Address
City
State
Zip
Father
Father's Occupation
Father's Cell
Father's Email
Mother
Mother's Occupation
Mother's Cell
Mother's Email
Mother born Jewish?
- Please Select -
Yes
No
Converted by whom?
Referred by
Emergency Information
Emergency Contact 1
Phone Number
Emergency Contact 2
Phone Number
Doctor's Name
Doctor's Phone Number
Medical Insurance Company
Shabbat Experience
We are excited to implement a Shabbat experience for our CHS families on the first Shabbat of the month, which is thoughtfully crafted to provide you with a joyful, easy-to-follow, and interactive experience, making you feel at ease and engaged with the prayers and songs while your kids enjoy a fun and engaging program.
Commit
We commit to attending the Shabbat experience monthly.
Tuition Information
Non members CHS Tuition: $1000 (includes book fee) | Members CHS Tuition 10% off - $900 (includes book fee) Family Membership: $950 Includes a discounted Hebrew School rate and a variety of additional perks. Select "Member Registration" below to view full benefits. Fees (per family) $100 security fee $100 registration fee Referral Bonus: If you refer a friend, let us know, and you'll receive a $25 discount.
Registration Type
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Member Registration
Non Member Registration
Membership Status
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I would like to renew my membership
I would like to become a new member
Membership Benefits Free High Holiday Services (refer below for details) A family member receives an honor during High Holiday Services A box of Shmurah Matzah for Pesach $150 discount on Preschool Discount in Hebrew School 20% discount on most events and programs 30% discount on Bar/Bat Mitzvah fees (after 1st year of membership – must be enrolled in our Hebrew School) Menorah & Candles for Chanukah mailed to college age children at school Shiva services Belonging to amazing Jewish community & building lifelong friendships.
Hebrew School Registration & Security Fee
CHS Tuition Payment Options
Enter Promo Code: member
Discount:
Final Amount:
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Family Info
Please indicate any information that needs to be updated from last year
Comments
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Payment Method
Credit Card Information
Type
Visa
MC
Amex
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Number
Expiration
/
Code
Use contact info above
Name
Address
Zip
Additional Comments
Additional Comments
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