Printed from ChabadSilverSpring.com

Hebrew School Registration

Hebrew School Registration 2018- 2019
We are currently accepting application forms for the 2018-2019 school year. This year we will be having Hebrew School on Sunday morning at Chabad of Silver Spring and Wednesday afternoon at the Woodside Synagogue in Downtown Silver Spring. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, feel free to contact our director Chaya Wolvovsky at 301-593-1117 or email silverspringchabad@gmail.com.
Please complete one registration form per child.
Student Profile
Full Name
First NameLast Name
Hebrew Name
Age
Birth Date
MonthDayYear
School
Grade Entering
Hebrew Reading Proficiency
NoneSomewhatWell
Previous Jewish Education
YesNo
Where?
Parent Information

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number
Area CodePhone Number
Father's Name
First NameLast Name
Father's Occupation
Father's Cell Number
Area CodePhone Number
Mother's Name
First NameLast Name
Mother's Occupation
Mother born Jewish?
YesNo
Mother's Cell Number
Area CodePhone Number
Mother's E-mail
Emergency Information
Emergency Contact 1
First NameLast Name
Phone Number
Area CodePhone Number
Emergency Contact 2
Phone Number
Area CodePhone Number
Doctor's Name
Doctor's Phone Number
Area CodePhone Number
Medical Insurance Company
Policy Number
CONFIDENTIAL: Does your child have any allergies or other medical condition that we should be aware of? If yes, please describe them and indicatte special precautions or care needed.
Registration Payment Agreement
Tuition for the year, per child for Sunday ONLY: $900
Tuition for the year, per child for Wednesday ONLY: $900

Tuition for the year, per child for Sunday and Wednesday: $1500
Tuition Payment Method:
Tuition can be paid in a single payment, two payments in September and January, or nine monthly payments between September and May.
If you would like to make payments by credit card please put in your information here and we will set up payments. If you would like to make payments by check, please have your bank send regular checks or provide us with post-dated checks that we can deposit on the dates indicated.
Program Registration*
Sundays OnlyWednesdays OnlySundays and Wednesdays
Payment Schedule*
Single PaymentTwo Payments (September and January)Nine Monthly Payments (September through May)

Payment*

Credit Card Check

Postal / Zip Code

Country

Total Payment
$900$1500
Should be Empty:

This page uses TLS encryption to keep your data secure.

Hebrew School Registration 2018- 2019

More in this section