Returning Student Hebrew School Enrollment

Returning Student Hebrew School Enrollment
This form is for returning students. For New Students, we ask that you contact us first and have a phone or in person meeting and then fill out the new student form. You may reach out to us at [email protected] or by calling 978-443-0110
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 Hebrew Name

First Name Last Name
Child's Birth Date

Month Day Year
Grade Entering
Child Name

First Name Last Name
Birth Date

Month Day Year
Grade Entering
Full Name

First Name Last Name
Birth Date

Month Day Year
Grade Entering
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?

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

Credit Card Other

Postal / Zip Code

Country

Tuition Payment Options

One Payment of $1025 per student for Sign Up's before June 30th or after July 1st $1050 per studentThree Part Payment PlanWe would like to discuss a Scholarship
Total

$0.00
Should be Empty:

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