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Registration

Registration

Registration

ECO_012 - reg download.jpg Register today to ensure a Jewish tomorrow.

Click here to download a PDF registration form.

To register online, fill out the form below.

If you have any questions, feel free to contact our Hebrew School director, Mrs. Hadassah Heber: (914) 962-1111, who will be happy to discuss your child with you!

Chabad Hebrew School / CTeen
Online Registration Form

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.

If you are registering a student that was in our Hebrew school last year, you can just fill in any updated info. as well as the tuition section.

If you would prefer to fill out this form and mail it into our office, a PDF registration form can be found here.

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

Hebrew School
CTeen

Student Profile
First Name
Last Name
Hebrew Name
DOB
Gender Male Female
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Hebrew Speaking Proficiency None Somewhat Well
Previous Jewish Education/Hebrew School Yes No
If yes, please describe
Synagogue affiliated with
Natural mother of child Jewish? Yes No
Conversions / adoptions in family? Yes No
If yes, please describe
Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):


Parent Information
Father's Name
Mother's Name
Home Phone
Father Cell Phone
Mother Cell Phone
Father's Work Phone
Mother's Work Phone
Father's Email
Mother's Email
Address
City
State
Zip
Spouse's Address and Home Phone (if different):

Emergency Information
Emergency Contact
Relationship to child
Home Phone
Cell Phone
Child Physician or Medical Facility
Physician Phone
Up to date with vaccinations? Yes No
Last tetanus shot date? mm/dd/yr


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:


___________________________________

Pay Online

For your convenience, you can now pay for Hebrew School online.

This page uses a secure connection and your information will not be shared with anyone.

Annual Hebrew School tuition: $650 (registration and book fee included).
CTeen Annual Tuition: $180 (Does not include NYC Shabbaton).



I would like to pay by check (by mail or in person)
Please write checks to: Chabad of Yorktown
2629 Old Yorktown Rd, Yorktown Heights, NY 10598

Amount: $
Card Number
Name on Card
Address
City
State
Zip
Card Type

Exp. Date

Security code 

 

 

I heard about the Chabad Hebrew School from:

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

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