Hebrew Sign-Up Form

1
Student's Name* This field is required.
First Name
Last Name
2
Student's Grade* This field is required.
Please Select
Please Select
4th/Dalet
5th/Hey
6th/Vav
3
Parent/Guardian Email* This field is required.This is the email address that your child's teacher will use to share information about accessing learning materials, homework, student progress, schedule changes. etc.
example@example.com
4
Additional Parent/Guardian EmailIf schedule and/or materials should also be shared with another parent or family member, please list their email address here
example@example.com
5
Do you want in-person (small-group) or remote (1-on-1) Hebrew Decoding instruction?
In-person (small-group)
Remote (1-on-1)
6
Confirm your session time for in-person, small-group Hebrew Decoding (4th & 5th graders only):Classes begin on Tuesday, September 30 at Temple Sinai
Tuesdays at 4:00pm
Tuesdays at 5:00pm
7
Preferred Session Day
Please Select
Please Select
Sunday
Monday
Tuesday
Wednesday
Thursday
Choose your preferred weekday for your child's weekly session
8
Preferred Session Start TimeChoose your preferred start time for your child's weekly session. Sessions will be 30-40 minutes for 4th and 5th graders and 45-55 minutes for 6th graders. Your assigned time will be confirmed by your child's teacher. Weekly sessions will begin in October.
Please Select
Please Select
3:00pm
3:15pm
3:30pm
3:45pm
4:00pm
4:15pm
4:30pm
4:45pm
5:00pm
5:15pm
5:30pm
5:45pm
6:00pm
6:15pm
6:30pm
6:45pm
Choose your preferred start time for your child's weekly session
9
Second Choice Session Start TimePlease choose a backup in case your preferred time is not available
Please Select
Please Select
3:00pm
3:15pm
3:30pm
3:45pm
4:00pm
4:15pm
4:30pm
4:45pm
5:00pm
5:15pm
5:30pm
5:45pm
6:00pm
6:15pm
6:30pm
6:45pm
Choose your preferred start time for your child's weekly session
10
Parent/Guardian Phone Number* This field is required.Please list a cellphone number for a parent who can be reached during your child's session if technical assistance is needed
11
Any additional comments, questions, concerns? Something we should consider when matching your child with a teacher? Let us know here!
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