PHDS APPLICATION FOR ADMISSION

APPLICATION FOR ADMISSION
How many children are applying to PHDS?

12
Applicant's Name*

First NameMiddle NameLast Name
Applicant 2's Name

First NameMiddle NameLast Name
Date of Application

MonthDayYear
Date

Applicant Information
Applicant's Full Hebrew Name*
Gender*
Date of Birth*
Age calculator
Age
Hebrew Date of Birth
Place of Birth
Primary Language Spoken at Home
Current Grade*
Current School*
School Phone Number
Please enter a valid phone number.
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant 2 Full Hebrew Name*
Applicant 2 Gender*
Applicant 2 Date of Birth*
Applicant 2 Age calculaor
Applicant 2 Age
Applicant 2 Hebrew Date of Birth
Applicant 2 Place of Birth
Applicant 2 Primary Language Spoken at Home
Applicant 2 Current Grade*
Applicant 2 Current School*
Applicant 2 School Phone Number
Please enter a valid phone number.
Applicant 2 School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PREVIOUS SCHOOL INFORMATION
Please list the school(s) that your child(ren)[applicants] attended in the past, including start and end dates.*
I give permission for Philadelphia Hebrew Day School to contact any previous schools (listed below) that my child attended.*

Clear
Name of School
Contact Name /phone
Name of School
Contact Name /phone
Name of School
Contact Name /phone
We require a letter of recommendation from your child's current school. In order for them to release information about your child, you will first need to sign a release form. Please print these forms. Submit the release to your child's current school and have them fill out and return the Prior School Information form to us at their earliest convenience.

Please Click Here to download the Release of Records form.

Please Click Here to download the Prior School Information form to be completed by your child's current school.

GRANDPARENTS

Grandparents are a part of the PHDS family too! They will be warmly invited to attend key school events and witness their grandchildren in action. Please fill out the information below, so that we can get to know them better.
Paternal Grandfather deceasedMaternal Grandmother deceasedPaternal Grandfather deceasedMaternal Grandmother deceased
Paternal Grandparents' Full Names
Paternal Grandparents' Phone
Please enter a valid phone number.
Paternal Grandparents' Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Paternal Grandmother's email
example@example.com
Paternal Grandfather's email
example@example.com
Maternal Grandparents' Full Names
Maternal Grandparents Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Maternal Grandparent's Phone
Please enter a valid phone number.
Maternal Grandmother's email
example@example.com
Maternal Grandfather's email
example@example.com

ADDITIONAL INFORMATION
Marital status of applicant’s parents:

MarriedSeparatedDivorcedFather DeceasedMother Deceased
If parents are divorced:

Father remarriedMother remarried
Name of step-parent(s)
Please explain custodial arrangements if applicant’s parents are separated or divorced (such as primary custody, visitation rights, etc)
Are there any legal guardians who are not the child's parents?

NoYes
Name of legal guardian

First NameLast Name
Relationship to applicant
Address of legal guardian

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of legal guardian

First NameLast Name
Relationship to applicant
Address of second legal guardian

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is there any other family information you would like to share?

PERTINENT JEWISH INFORMATION
Synagogue Affiliation*
Name
Synagogue Location
City, State
Frequency of Parent Attendance

DailyWeeklyOn the big holidaysWe don't attend
Please include information about any family member(s) having undergone conversion, such as yourself, a spouse, grandparent, child or siblings. Please include certificate(s) of conversion.
Please upload conversion certificates.

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Is there any additional information you would like us to know about you, your child, or your family in regards to Jewish affiliation and connection?

APPLICANT PERSONAL INFORMATION

Child 1 if Multiple applicatnts
How did you learn about Philadelphia Hebrew Day School? Please indicate your reasons for choosing this school.*
Please describe your child, so that we might get to know him/her better. *
Are there any physical or emotional challenges to be aware of? If so, please explain.*
My child receives support (tutoring, counseling, medical etc.) or could benefit from support in the following ways:
Has your child been tested or evaluated for any special academic, behavioral or emotional concerns? Please explain and include a copy of evaluation. Has your child received or are they currently receiving any services? *
Please upload a copy of your child's evaluation, IEP, and any other related documents.

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Does your child take any medications on a regular basis or have any medical concerns that the school should be aware of? *
What else would you like us to know about your child?

CHILD PROFILE

As the parent, you know your child best. We welcome your unique insight to help us better serve your child. Please describe your child in each of the following areas
Developing self-image:
Social relationships with peers and adults.
Special needs/accommodations:
Ability to follow through on simple directions:
APPLICANT PERSONAL INFORMATION

Child 2 if Multiple applicants
Please describe your child, so that we might get to know him/her better. *
Are there any physical or emotional challenges to be aware of? If so, please explain.*
My child receives support (tutoring, counseling, medical etc.) or could benefit from support in the following ways:
Has your child been tested or evaluated for any special academic, behavioral or emotional concerns? Please explain and include a copy of evaluation. Has your child received or are they currently receiving any services? *
Please upload a copy of your child's evaluation, IEP, and any other related documents.

Cancelof
Does your child take any medications on a regular basis or have any medical concerns that the school should be aware of? *
What else would you like us to know about your child?
CHILD 2 PROFILE

As the parent, you know your child best. We welcome your unique insight to help us better serve your child. Please describe your child in each of the following areas
Developing self-image:
Social relationships with peers and adults.
Special needs/accommodations:
Ability to follow through on simple directions:

ENROLLMENT TERMS AND CONDITIONS
This application is a request to enroll my child in PHDS for the 2024-2025 school year. I understand that the application will not be accepted and processed until the registration fee is paid in full. I have read and accept the Terms & Conditions of the enrollment contract as outlined below. Enrollment is conditional upon acceptance of all conditions below. When accepted by PHDS, I understand that this contract is legally binding.

1. By paying your registration fee you are guaranteed a placement for your child for the 2024-2025 school year, pending acceptance by PHDS.
2. In the Spring you will receive a Tuition Contract for your signature. Admission to PHDS will be finalized upon receipt of your completed Tuition Contract.
3. Rules and Regulations: The parents and the student(s) agree to be bound by the rules and regulations of PHDS as stated in its publications and in any additions or amendments to those rules and regulations that may be announced from time to time.
Parent Signature*

Clear
Parent Signature*

Clear
A $250 non-refundable registration fee per child must accompany this contract to reserve a placement for your child. This registration fee is not a deposit towards tuition and must be paid whether or not a family is applying for financial assistance. This fee is non-refundable barring unusual circumstances or non-acceptance of your child. Admission to Philadelphia Hebrew Day School is not guaranteed without this fee and a signed tuition contract which you will receive later in the year.

Registration Fee

Pay Registration FeeEnter description

$250.00 QuantityOption
Item subtotal:$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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APPLICATION FOR ADMISSION

Applicant Information

Parent Information

Parent Information

PREVIOUS SCHOOL INFORMATION

GRANDPARENTS

ADDITIONAL INFORMATION

PERTINENT JEWISH INFORMATION

APPLICANT PERSONAL INFORMATION

CHILD PROFILE

APPLICANT PERSONAL INFORMATION

CHILD 2 PROFILE

ENROLLMENT TERMS AND CONDITIONS