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HS Application Form

HS Application Form

Online Application

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.

** Please Note - Acceptance to the school is pending director's approval.

Student Profile #1
First Name
Last Name
Hebrew Name
Gender
DOB
School
Grade Entering (Sept. 2017)
Student Profile #2
First Name
Last Name
Hebrew Name
Gender
DOB
School
Grade Entering (Sept. 2017)

 

Student Profile #3
First Name
Last Name
Hebrew Name
Gender
DOB
School
Grade Entering (Sept. 2017)
Parent Information
Father's Name
Mother's Name
Address
City, State, Zip
Phone
Cell Phone Mother  
Cell Phone Father
E-mail Address

   

Are both parents Jewish? Yes No

To your recollection have there been any conversions or adoptions in the family? No Yes
If yes please explain :

 

Tuition:
Kindergarten (9:30 – 12:00) $550
First Grade (9:30 – 12:00) $600
Second Grade (9:03 – 12:00) $600
Third Grade (9:30 – 12:00) $750
Fourth Grade (9:30 – 12:00) $750
Fifth Grade (9:30 – 12:00) $750
Sixth Grade (9:30 – 12:00) $750
Additional afternoon for 3 - 6 grade $300
   
7th & 8th Grades, weekday 6-7:00pm $400
Payment Options
Pay Full Tuition now.

Four payments, August 1, 2017, October 1, 2017,
December 1, 2017, and February 1, 2018

Name on Card:
Card Type
Card Number
Exp. Date
CCV Number (on back of card)
Comments (optional)


We hire and make commitments to our staff based on registrations received, and therefore we absolutely cannot refund any deposit or tuition payments.

I understand that my deposit of $100 per child is non-refundable, that full payment or payment plan is due by August 1, 2017, at which time the balance of tuition becomes non-refundable, and that refunds will not be made for incomplete attendance. The parent/guardian who signs this registration form represents that he/she has full authority to do so and will be responsible for payment of the Hebrew School fees.

I Accept

Name:

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

~~
If needed, please call our office 847-808-7770 x 105, for a
paper copy of the registration form.

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