Printed from JewishDelco.org

Register Online

Register Online

Register Online

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 that one registration form per child is needed.

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

Student Profile
 
Name
Last
Hebrew Name
DOB
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Where?
Parent Information
 
Father's Name
Cell Phone
Is the child's father Jewish?  Yes    No
Mother's Name
Cell Phone
Is the child's mother Jewish?  Yes   No
Address
City
State
Zip
Email Address
Were there any conversions or adoptions in the family?  Yes  No
if yes, please explain:
Emergency Information
 
Emergency Contact 1
Phone
Emergency Contact 2
Phone

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.



As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Name: Initials:

 

PAYMENT OPTIONS


• Tuition for the 2017/18 school year is $600 per Child.

I will pay by check (full amount or up to three post-dated checks of $200.00).

Please write and mail check to: Chabad Lubavitch of Delco - 19 Mather Ave, Broomall, PA 19008

I will pay by credit card
(Please call the Rabbi if a payment plan is necessary.)

Name on card   Card Type
Charge Amnt.   Card Number
Exp. Date   CVV Code 3 digits on back of card

 

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

 

Secure This page uses 128 bit SSL encryption to keep your data secure.

Updates
First day of Hebrew School is September 12, 2017
Upcoming events
Jul. 24, 2017
Jul. 27, 2017
Jul. 31, 2017