22-23 New Student Application and Enrollment Contract

New Student Application and Enrollment Contract
WELCOME! Admission Information and How to Apply

Thank you for your interest in applying to The Hebrew Academy. We look forward to welcoming your family to The Hebrew Academy family!

The Admissions office is here to assist you with any questions you may have. If you have any questions, please contact Linda Glickstein, Director of Admissions at 732-431-5525 or linda@thanj.org.

Please note that our admissions process requires both an Application for Admission and New Student Contract for each new student. For questions regarding financing or to apply for a Scholarship Grant, please contact The Hebrew Academy Business Manager, Laurie Shapiro at 732-431-5525, or laurie@thanj.org.

Did you complete your application? Your application is complete when we have received the following:
1. Completed New Student Contract
2. Completed Application For Admission
3. $850 Deposit, per student
4. Teacher Evaluation Forms
5. Official Transcripts, including Report Cards, Standardized Tests, etc.
6. Copy of Birth Certificate
7. Health Records
8. Release of Records Request
Once your application is complete, we will be in touch to schedule a visit for your child(ren).

We encourage you to take advantage of the following

April 1, 2022 Early Action Discounts*

Early Childhood Discounts:
- 20% Discount for all full-time students entering Transition, Nursery, and Pre-K.
- 15% Discount for all full time Kindergarten.
Current Family Priority Deadline:
- $600 Early Action Discount for All Students Entering Grades 1 and 6, 7, 8 & Not Receiving A Scholarship Grant, with completed application and full deposit* (per student).
- $350 Early Action Discount for All Students, (all grades), Not Receiving a Scholarship Grant, or other Early Action Discount, with completed application and full deposit* (per student).
Scholarship Grant Application Deadline:
- April 1, 2022: In order to expedite the Scholarship Grant process, the 2021 Tax Return is not requested at this time.
June 3, 2022 Pre-Payment Deadline:
- Early Childhood of $150 and $250 for Grades 1-8 if Full Payment is Submitted with Completed Application By June 3, 2022 (Per Student).
  
  IN ALL CASES, DEPOSITS WILL BE CREDITED AGAINST TUITION BILLS.
  
  *With Full Deposit of $800 (Current Students) and $850 (New Students)

Parent/Guardian Information

Please enter both parent/guardian information
DIRECTIONS: Complete both “Parent and Guardian” sections unless the applicant has only one parent. In case of divorce, where both parents have custodial responsibilities, both sections must be completed AND BOTH PARENTS OR GUARDIANS MUST SIGN THE CONTRACT. Please note that in cases of divorce, unless we receive instructions to the contrary, the information about both parents listed in the contract will be included on school and class rosters.
Today's Date

Month Day Year
Date

Parent/Guardian
Parent/Guardian Full Name *

First Name Last Name
If Guardian, Relationship to Student:
Parent/Guardian Employer Name *
Parent/Guardian Job Title *
Parent/Guardian Email *
example@example.com
Parent/Guardian Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian Cell Phone *

Area Code Phone Number
Parent/Guardian Home Phone

Area Code Phone Number
Parent/Guardian Work Phone

Area Code Phone Number

Parent/Guardian 2
Parent/Guardian 2 Full Name

First Name Last Name
If Guardian, Relationship to Student:
Employer Name
Job Title
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian 2 Cell Phone

Area Code Phone Number
Parent/Guardian 2 Home Phone

Area Code Phone Number
Parent/Guardian 2 Work Phone

Area Code Phone Number

Parent/Guardian Information

Please enter both parent/guardian information
Marital Status Parent/Guardian: *

Married Separated Single Divorced
If parents are separated, divorced, describe custody arrangements:
Please specify any special mailing instructions (duplicate mailings, etc.):

Student Information

Please complete one application per student
The information requested on this application will be held in strict confidence.
The undersigned hereby apply for enrollment of the following child as a student in The Hebrew Academy (the “School”):
Applicant's Name *

First Name Last Name
Applicant's Hebrew Name *
Applicant's Birthdate *

Month Day Year
Date
Sex *
Applicant's Age
Place of Birth *
If not U.S, Date of Arrival
Family Email *
example@example.com
Home Phone Number *

Area Code Phone Number
Applicant(s) live with: *

Both Parents Mother Father Grandparents Guardian
Address if different than parents

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Candidate for Grade *
*For Toddler ONLY: Days/Hours if not full-time:
*For Transition and Nursery ONLY: please contact the Admission Office for options other than 5 days/week.
Names of Other Children in Family

Student Educational Information
Current School
Current Grade
School Principal
Current Teacher
School Number

Area Code Phone Number
School Fax

Area Code Phone Number
School Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Other Schools Attended by Applicant

Student Medical Information
Any and all information that helps create a more complete profile of your child is beneficial in understanding your child’s learning and social needs. Therefore, we require access to such information in order to consider this application complete.
Indicate if your child has ever been evaluated by a: *

Child Study Team Physical/occupational therapist Speech/language therapist Learning specialist or psychologist N/A
Please describe any services that are ongoing and submit all reports:
Are there any special issues in your child's history of which the school should be aware (medical/allergy concerns, physical or emotional development, family life, custodial arrangements, etc.)?

Student Background Information
As a Jewish Day School, The Hebrew Academy admits only Jewish children. This means children born of a Jewish mother (one who is Jewish by birth or by conversion), or a child who has undergone conversion. In either of these cases, please submit a copy of the conversion certificate.

Please select ALL that apply below.
Mother is Jewish *
Father is Jewish *
Child is Jewish *

Family/Special People Information (Optional)
The Hebrew Academy Alumni Relatives:

Maternal Grandparents and/or Special Person
Name

First Name Last Name
Email
example@example.com
Phone Number

Area Code Phone Number
Alumni of THA or SSDS
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Special Interests or Talents:

Paternal Grandparents and/or Special Person
Name

First Name Last Name
Email
example@example.com
Phone Number

Area Code Phone Number
Alumni of THA or SSDS
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Special Interests or Talents:

Terms & Conditions

You must read all of the Terms & Conditions BEFORE agreeing
By signing this Agreement electronically, I agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing and I hereby consent to be legally bound by the Terms and Conditions listed above. *

Parent/Guardian 2 Signature Clear
By signing this Agreement electronically, I agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing and I hereby consent to be legally bound by the Terms and Conditions listed above.

Parent/Guardian 2 Signature Clear

Tuition and Assessment Information
The following are Tuition and Assessment Fees for the 2022-2023 School Year. You will have the choice of paying in full (and receiving the full payment discount), or enrolling in the Blackbaud Tuition Management program.

(SMART) Blackbaud Tuition

Installment Plan (June 2022-March 2023) $65.00 fee applies
Would you like to sign up for (SMART) Blackbaud Tuition? *

Yes No
For Security Compliance reasons we cannot gather your bank account information through this form. Please download the below form, fill it out completely, and return it by emailng laurie@thanj.org.

Submission Deadline 4/1/2021
Upload your signed document here

Browse Files

Cancel of

THA Scholarship Program

Note: Scholarship Grant applies to students entering grades 1-8 only.
I/we wish to receive information about the The Hebrew Academy Scholarship Grant Program, based on family need. *

Yes No
The following are Tuition and Assessment Fees for the 2022-2023 School Year. You will have the choice of paying in full (and receiving the full payment discount), or enrolling in the Blackbaud Tuition Management program.

Kids' Care Services

Annual contract and Kids' Care drop-in services are available.
You can download the form below. Please return this completed form along with the appropriate paperwork to the Business Office by the below deadline.

Submissions Deadline: 4/1/2022
Would you like to utilize Kids' Care Services? *

Yes No

Bus Services
The Hebrew Academy offers central stop bus service (not door to door) from the Toms River/Lakewood, Ocean County areas as well as Eatontown/West Long Branch/Ocean Twp., Monmouth County areas. Are you interested in obtaining information regarding bus service? *

Yes No

Bus Services
Student(s) Current Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Select an Area
Please Select One

Round Trip One Way (AM) One Way (PM)
Payment Terms & Policies
Please Choose Your Preferred Payment Method:

Paid in full prior to the start of the school year Your balance will be included as part of your monthly SMART payment
By signing this Shore Bus Route Contract electronically, I agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing and I hereby consent to be legally bound by the Payment Terms and Policies listed on the previous page.

Clear

Transportation Reimbursement

You MAY be eligible
The New Jersey Department of Education submission date for the B6T (Application for Private School Transportation Reimbursement), for the 202-2023 school year, must be filed with your home township by March 4, 2022.
Does your K-8th grade student(s) reside more than 2 miles but less than 20 miles from The Hebrew Academy? *

Yes No
ADDITIONAL INFORMATION

Whether your child will be using private bus service or will be transported to school by car, every student in grades K – 8, is entitled to a transportation reimbursement for attending a private school and not using state funded busing.

The only exceptions are for those students living more than 20 miles or less than 2 miles from the school, and for those Kindergarten students that do not make the cut-off in their home districts. The 2021-2022 reimbursement was $1,000.00 per student.
Please download the below form, fill it out completely, and return it by emailng scott@thanj.org or by uploading it on this screen to this form by 3/5/2021. We have been advised that failing to file by this date may result in transportation aid days being deducted from your total.

Your timely attention to this matter is greatly appreciated. Should you have any questions, please feel free to contact the office at (732) 431-5525.

1 per student is required.

Submission Deadline 3/4/2022
Upload completed form

Browse Files

Cancel of

Synagogue Affiliation
We consider our family: *

Conservative Reform Traditional Orthodox Chabad
Membership
We attend:
Synagogue Name - If you do not attend Synagogue please write in None.

Annual Travel Permission Form
This permission form will apply to all school trips for the current school year. Prior to each trip, you will receive a Trip Information Form which you do not have to sign or return to the office unless you do not wish your child to go on that particular trip. This Travel Permission Form will be used only for the current school year.

I give permission to The Hebrew Academy to transport my child/children on school trips during the current school year. I understand that I will receive a Trip Information Form prior to each trip.
By signing this electronically, I agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing. *

Parent/Guardian Signature Clear

Annual Photo, Student Work & Social Media Permission Form
The Hebrew Academy is well known in the surrounding communities. We owe this to an organized promotional program as well as to our reputation as an excellent school. The promotional program often includes media coverage, including articles, photographs, and on our The Hebrew Academy website. In addition, we now publish school videos on a secure YouTube Video site. From time-to-time the school may wish to publish examples of student projects, photographs of students, and other work on the Internet. PLEASE NOTE: We will only select students who have a signed this release form (YES). If you do not want your child’s name, photo or quote published, please check (NO). The form will be valid for the school year only.
Permission *

Yes, I give permission to The Hebrew Academy to release photographs, videos, and quotes of my child/children for publication (in print, electronic, and video, including Facebook) during the school year: No, I do not give permission to The Hebrew Academy to release photographs, videos, and quotes of my child/children for publication (in print, electronic, and video, including Facebook) during the school year.
By signing this electronically, I agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing. *

Parent/Guardian Signature Clear

Release of Records Request

To Parents/Guardians of Applying Students: Please fill in the required information below, sign, and submit to The Hebrew Academy Admissions Office.
Name of Current School *
Principal *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
I request that the school record for my child be forwarded to the The Hebrew Academy, for the purpose of admission review and academic placement. I also understand that this release will allow The Hebrew Academy to contact teachers or other professionals, as needed, from the applicant’s current school.
Child's Name *

First Name Last Name
Child's Grade *
Parent/Guardian Name *

First Name Last Name
By signing this electronically, I agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing. *

Parent/Guardian Signature Clear
To the School Official: This student has applied for admission to our school.

Thank you in advance for submitting the following information:
1. Transcript of academic record or report cards, including courses taken and grades received
2. Attendance Records
3. Results of standardized achievement and/or aptitude tests
4. Copies of learning and/or psychological evaluations, i.e., Child Study Team evaluations.
5. Copies of health records and medical forms
6. Completed Teacher Evaluation form found at this link (feel free to share it with any teachers needing to fill it out) https://form.jotform.com/193424790823160
Please send all information to:

The Hebrew Academy

P.O. Box 203, Marlboro, NJ 07746, ATTENTION: ADMISSIONS

Application for Admission
We understand that if any information has been withheld or falsified, The Hebrew Academy reserves the right to deny admission or discontinue serving my/our child. If accepted, I/we agree to abide by school policies and policies.
By signing this Application for Admission electronically, I/we agree that my electronic signature is the legal equivalent of my manual signature, as if actually signed by me in writing and I hereby certify that the information herein is true and reliable. *

Parent/Guardian Signature Clear

Payment

FINAL Enrollment Step
We encourage you to take advantage of the following

April 1, 2022 Early Action Discounts*

Early Childhood Discounts:

20% Discount for all full-time students entering Transition, Nursery, and Pre-K.
15% Discount for all full time Kindergarten.

Current Family Priority Deadline:
- $600 Early Action Discount for All Students Entering Grades 1 and 6, 7, 8 & Not Receiving A Scholarship Grant, with completed application and full deposit* (per student).
- $350 Early Action Discount for All Students, (all grades), Not Receiving a Scholarship Grant, or other Early Action Discount, with completed application and full deposit* (per student).
Scholarship Grant Application Deadline:
- April 1, 2022 In order to expedite the Scholarship Grant process, the 2021 Tax Return is not requested at this time.
June 3, 2022 Pre-Payment Deadline:
- Early Childhood of $150 and $250 for Grades 1-8 if Full Payment is Submitted with Completed Application By June 3, 2022 (Per Student).
  
  IN ALL CASES, DEPOSITS WILL BE CREDITED AGAINST TUITION BILLS.
  
  *With Full Deposit of $800 (Current Students) and $850 (New Students)
You may pay your deposit and additional fees by credit card or your Bank Account (e-Check).

There is an additional 3% added to payments made by Credit Card.

If you choose to pay with your Bank Account please use the Discount Code THA2022 to remove the additional credit card fees.

Your total amount due is listed below. When you select the Pay Now button you will be re-directed to a secure site to submit your payment.
ACH (e-Check) Totals
Credit Card Totals
Deposit
Total Amount due if paying by e-Check
Deposit
Total Amount due if paying by Credit Card
Kids' Care
Total Amount due if paying by e-Check
Kids' Care
Total Amount due if paying by Credit Card
Student Account
Total Amount due if paying by e-Check
Student Account
Total Amount due if paying by Credit Card
Total Amount Due
Total Amount due if paying by e-Check
Total Amount Due
Total Amount due if paying by Credit Card
If you run into any technical issues while filling out this form please Click Here and provide a brief description of the problem and/or a screen shot. Thank you!
Should be Empty:

New Student Application and Enrollment Contract

Parent/Guardian Information

Parent/Guardian Information

Student Information

Student Educational Information

Student Medical Information

Student Background Information

Family/Special People Information (Optional)

Terms & Conditions

Tuition and Assessment Information

(SMART) Blackbaud Tuition

THA Scholarship Program

Kids' Care Services

Kids' Care Annual Contract

Bus Services

Bus Services

Transportation Reimbursement

Synagogue Affiliation

Annual Travel Permission Form

Annual Photo, Student Work & Social Media Permission Form

Release of Records Request

Application for Admission

Payment