Please fill out this form as an initial registration for the Chabad Hebrew School.

Confirmation of acceptance will be acknowledged only after this registration form is reviewed and an acceptance letter is received.

Student Information

     Male Female

Does you child read basic Hebrew?
None  Somewhat Well

Does your child speak/understand Hebrew?  None  Somewhat Well

Does your child have previous Jewish Education Yes No
If yes, please describe:

What school does your child attend?  Grade entering:
Synagogue affiliated with:
Is the natural mother of the child Jewish? Yes No
Were there any conversions or adoptions in your family? Yes No
If yes, please describe:

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):


Parent Information





Emergency Contact Information
Please list two contacts to be used in case of emergencies (other than your home and business numbers).




Please send a copy of your insurance card for our files.

Up to date with vaccinations? Yes No           Date of last tetanus shot:

Accept  Do Not Accept
Initial here:  


Chabad Hebrew School Tuition Agreement

The following is a tuition agreement for the Chabad Hebrew School. The agreement explains the tuition fees, payments plans and refund policies. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes.

The tuition for the Chabad Hebrew School is $795.00 per year per child plus a $50.00 registration & book fee.

Discounts: There is a 10% discount off of the regular tuition for each additional child of the same family. There is a 10% additional discount off your total tuition for each child of another family you successfully introduce to the Chabad Hebrew School.

You may choose from the following payment methods:
PLAN A: You may pay the entire amount in full with a check, cash or credit card.

PLAN B: You may pay the annual tuition on a monthly basis by submitting 10 checks of $79.50 each, dated August through May, plus a $50.00 book fee. All checks must be submitted before the first day of Hebrew School.

PLAN C: You may use your credit card to pay the tuition on a monthly basis.  Your credit card will be billed $79.50 monthly August through May, plus a $50.00 book fee.  To do so please include your credit card number and expiration date at the bottom of this page.

Accept  Do Not Accept
Your FULL name here:  


Payment Options:
VISA MasterCard Discover American Express Check in mail

Check or Card No.

Check Date or Card Expiration: mm/yyyy /   CVC

I heard about the Chabad Hebrew School from: