Midrasha Registration 2025/2026

Midrasha Registration 2025-2026
STUDENT INFORMATION
Student Name*

First NameLast Name
Student Birthdate

MonthDayYear
Date
Student Pronouns*
(ex: she/her/hers, he/him/his, they/them/theirs)
Student Email*
(email is our primary mode of communication with students)
Student Phone*
Format: (000) 000-0000.
Entering Grade (Fall 2025)*
Please list any dietary, learning, or behavioral concerns that the director or your child’s teacher should be aware of, including observance of Kashrut, IEPs, medication, etc. *
Does this student have any allergies? Please list:*
ENROLLMENT

Please Note: There is an additional $20 per year charge for students choosing the Hebrew elective to cover the cost of workbooks. There is no additional tuition cost.
Fall Midrasha Hebrew High School (Wednesdays, 7:00 pm - 9:00 pm, at Beth Israel Center)Spring Midrasha Hebrew High School (Wednesdays, 7:00 pm - 9:00pm, at Temple Beth El)Hebrew (Wednesdays, 6:15 pm - 7:00 pm at Beth Israel Center Fall semester, Temple Beth El Spring semester)
FAMILY INFORMATION
Beth Israel CenterCongregation Shaarei ShamayimTemple Beth ElNot AffiliatedOther (explain)
Parent 1 Name*

First NameLast Name
Parent 1 Phone*
Format: (000) 000-0000.
Parent 1 Email*
Parent 1 Address*

Street Address (including apartment # if applicable)

Street Address Line 2

CityState

Zip Code
Parent 2 Name

First NameLast Name
Parent 2 Phone
Format: (000) 000-0000.
Parent 2 Email
Parent 2 Address

Street Address (including apartment # if applicable)

Street Address Line 2

CityState

Zip Code
Both ParentsParent 1Parent 2Splits time between both residencesOther (explain)
Emergency Contact*

First NameLast Name
Emergency Contact Phone*
Format: (000) 000-0000.
See Midrasha Policies Here
YesNo
YesNo
Yes, subscribe parent 1 emailYes, subscribe parent 2 emailAlready subscribed
Family member is a current or former studentMy congregation promoted this programAttended a recruitment eventA friend recommended it. Please share your friend's name below so they get credit for recruiting you!I saw it promoted by Jewish Federation of Madison (email, social media)I am a current Midrasha studentOther (explain)
Additional message or name of friend who recommended Midrasha to you
Tuition Cost:
• Non-Synagogue Affiliated - $545 for the full year ($272.50 per semester) per Midrasha student.
• Synagogue Affiliated - $498 for the full year ($249 per semester) per Midrasha student. (Families who are members of Beth Israel Center, Congregation Shaarei Shamayim, or Temple Beth El)

Workbook Cost:
• $20 per year per student (for those enrolled in Hebrew Elective only)

Option to pay for the full year or in two installments. Semester 1 payment is due with registration. Semester 2 payment is due by January 5, 2026. Tuition is payable by check or credit card. Credit card payments incur an additional 3% transaction fee.
How to Pay:

The payment system has changed for this year and it will be ran through Smartcare. After submitting this form, you will receive an invite to start using Smartcare in 3-5 business days. Please follow the steps in that email to make payment.
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Midrasha Registration 2025-2026