New Student Hebrew School Enrollment - Chabad Jewish Center of Sudbury

New Student Hebrew School Enrollment
Please note: Please contact us if you would like to learn more about the Hebrew School and the wonderful programs we offer.

Please contact us at [email protected] or call 978-443-0110

Following our intial conversation, please fill out this form.
Parent / Guardian #1
First Name Last Name
E-mail
Cell Phone Number

Area Code Phone Number
Parent / Guardian #2
First Name Last Name
E-mail
Cell Phone Number

Area Code Phone Number
Home Number

Area Code Phone Number
I would like to receive news and updates by email

Address

Child Name
First Name Last Name
Child's Birth Date

Month Day Year
Grade Entering
Child's Hebrew Name
Child Name
First Name Last Name
Birth Date

Month Day Year
Grade Entering
Child's Hebrew Name
Full Name
First Name Last Name
Birth Date

Month Day Year
Grade Entering
Child's Hebrew Name
Any considerations, such as learning disorder or difficulty, the teacher should be aware of? (Confidential)
Does your child have any allergies or other medical conditions we should be aware of? If yes, please describe them and indicate special precautions or care needed.
Please indicate if anyone besides yourself will be picking up your child
Additional notable Information
What are your child’s special interests, likes or dislikes?
Is the Biological Mother of the Child Jewish?

YesNo
Were there any Conversions or Adoptions in the Family? Please Explain

(Please note: Payments via credit card will be charged a 3% transaction fee)

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Credit Card Other

Postal / Zip Code

Country

Tuition Payment Options

One Payment of $1125 per student for Sign Up's before June 30th and after July 1st $1175 per studentThree Part Payment PlanWe would like to discuss a Scholarship
Total

$0.00
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