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Student Profile
 
Last Name
First Name
Hebrew Name
Age
DOB
Time of Birth - In Judaism the day begins at nightfall, so in order to determine the exact date of your Jewish birthday we need to know what time of day you were born.
School
Grade Entering
 
 
Hebrew Reading Proficiency
  None Somewhat Well
Previous Jewish Education Yes No
Where?
Does your child have an IEP and/or any learning disabilities? Please specify
(This information will help us better cater to the needs of your child.)

Parent Information

 
Father's Name
Home Phone
Father's Cell
Father's Email
Mother's Name
Home Phone
Mother's Cell
Mother's Email
Address
City/Zip
Email Address you would like a copy of the form emailed to:
Emergency Information
 
Emergency Contact
Home Phone
Work Phone
Cell Phone
Doctor's Name
Doctor's Phone Number

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

Registration Payment Agreement

No Membership is necessary to attend Chabad Hebrew School. Tuition for a full year of CHS (August, 2017- May 2018) is $500.00. For multiple siblings and members, we offer an additional 10% off. In addition, all registrations received with a first payment by June 30th, 2017 will be eligible for a $50 early bird discount.

Please choose one of the following payment plans.

If you would like to spread out your payments, or need other confidential financial arrangements, please be in touch with Rabbi Nemes. No child will be turned down from CHS due to lack of funds. Rabbi Nemes can be reached at rabbi@jewishlouisiana.com or 504-957-4986.

Tuiton Plans:

Pay in full before year starts
Pay in two installments: first with registration, second in January 2017
Pay in three installments: first with registration, second in November, 3rd in February
As per our discussion, the following payment plan will be put in place:

Method of Payment
Check Credit Card Cash
     
CC Type   Card Number
Billing Address   City, State, Zip
CVV   Exp Date
Total Registration Cost:
 
Parent Involvement

Please indicate whether you would be willing to be involved in one or more of the following volunteer activities:

Volunteering for our Aleph Champ Hebrew Reading program. If yes, how often?

Please let us know about other volunteer activities.

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