New Students Hebrew School Info Form

Please complete this information form. You will receive a response within 24 hours of submission 

Child Info: 

First Name         Last Name       Hebrew Name (if known)    

DOB                        School                  Grade Entering                    

Hebrew Reading Proficiency (if any)      

Previous Jewish Education (if any)         

Is the natural mother of the child/ren Jewish?         YES        NO

Where there any conversions or adoptions in the family? Please explain. (If yes, is the conversion recognized and approved by the Chief Rabbinate of Israel) 

Parent Info:

Address       City      Zip   

Home Phone       

Father's Name       Cell Phone         Email     

Mother's Name      Cell Phone         Email