Shalom Hebrew Family Registration Form

Shalom Hebrew Family Registration Form

Please fill out this form for registration
Family Name *
Family Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Father's Name
Father's Phone Number
Please enter a valid phone number.
Father's Email
example@example.com
Mother's Name *
Mother's Phone Number *
Please enter a valid phone number.
Mother's Email *
example@example.com
Is the biological mother of the child/ren Jewish? *
Child 1 Name *

First Name Middle Name Hebrew Name
Child 1 Birth Date *

Month Day Year
Child 2 Name

First Name Middle Name Hebrew Name
Child 2 Birth Date

Month Day Year
Child 3 Name

First Name Middle Name Hebrew Name
Child 3 Birth Date

Month Day Year
Do your child/ren have any allergies or other medical condition we should be aware of? (Confidential) If yes, please describe them and indicate special precautions or care needed.
Any considerations, such as learning disorder or difficulty, the teacher should be aware of?(Confidential)
What are your child/ren’s special interests, likes or dislikes?

Family Tuition Agreement
We are super excited for the upcoming Hebrew school year!

This year Shalom Hebrew will consist of three components

- Virtual Hebrew School with live teachers on Sundays from 10:00 AM to 11:30 AM. These classes are specially designed to be exciting and engaging. Supplies will be safely prepared for each student.

- Weekly one-on-one Hebrew reading tutoring

- In-person events for special occasions, i.e. Rosh Hashanah. These in-person events will be outside and follow the CDC Covid related guidelines including mask wearing, social distancing and sanitizing etc.

Tuition for the 2020-21 school year is $880 (includes supplies and snacks)

Discounts:
Early Bird Discount: Take off $50 per child when registering before August 20th 2020.
Refer a Friend: Take off $20 for every family that registers on your recommendation.
Please check your choice of payment method

Online Payment for the full amount Check written to Shalom Hebrew for the full amount One payment now (online/check) for half tuition and another payment due December 1st 2020 I need a more flexible plan - Please send a deposit of $200 per child (online/check) and call/email Bina to discuss a personal payment plan.
Registration Deadline is September 1st 2020
All applications received after September 1st will be charged an additional $100 late fee.
This application and tuition agreement must be completed BEFORE your child may begin attending school.
No child will be turned away due to lack of funds. Please email SHebrewSchool@gmail.com or contact our office at (201)-438-4931 to discuss any financial considerations.
There are no refunds or credits for days missed due to illness, holidays, or family vacations.
We look forward to a wonderful year of learning and growth!
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Full Tuition
$ 830.00 Early Bird

Half Tuition
$ 390.00 Early Bird

Covid surcharge (optional)
$ 36.00

Total

$ 0.00

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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Shalom Hebrew Family Registration Form

Family Tuition Agreement