Hebrew School Registration - Chabad of Silver Spring

We are currently accepting application forms for the 2020-2021 school year. This year we will be having two tracks. 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 [email protected]

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 Cell Number

Area CodePhone Number

Mother's Name

First NameLast Name

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

Hebrew School @ Chabad:
Tuition for the year, per child for Sunday ONLY: $1,000
Tuition for the year, per child for Wednesday ONLY: $1,000
Tuition for the year, per child for Sunday and Wednesday: $1,600

Hebrew School 2 U:
Tuition for the year, per child for once a week: $1,400
Tuition for the year, per child for twice a week: $2,400

If three or more children at location:
Tuition for the year, per child for once a week: $1,200
Tuition for the year, per child for twice a week: $2,000

Virtual Hebrew School (with all books and supplies provided):
Tuition for the year, per child for Sunday ONLY: $1,000
Tuition for the year, per child for Wednesday ONLY: $1,000
Tuition for the year, per child for Sunday and Wednesday: $1,600

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.

Track Selection:*

Hebrew School @ ChabadHebrew School 2 UVirtual Hebrew school

Payment Schedule

Single PaymentTwo Payments (September and January)Nine Monthly Payments (September through May)

Total to be charged today:*

$

Total

$0.00

Payment*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Hebrew School Registration 2020-21