Please note this form is for RETURNING STUDENTS ONLY! If this is your first year applying to our Hebrew School please fill out the New Student Form. Parent and Family Info Full Name:* First Name Last Name Adult #2 Name: First Name Last Name Emergency Contact Name: First Name Last Name Emergency Contact Cell Phone Number: Area Code Phone Number Emergency Contact Second Phone Number: Area Code Phone Number Student's Info Child's Name:* First Name Last Name Child's Hebrew Name:* Date of Birth:* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Time of Birth:* 123456789101112 Hour001020304050 MinutesAMPM Grade (Entering into the 2025/2026 school year)* Kindergarten 1st grade 2nd grade 3rd grade4th grade5th grade 6th grade 7th grade Program Selection:* "First Taste" Program (grades K & 1) Sunday’s, 9:30am - 12:00pm - $1050Hebrew School (grades 2-7) Sunday, 9:30am - 12:00pm & Wednesday 4:30pm - 6:00pm - $1400 Child #1 T-Shirt Size:* Add another child Child #2 Name:* First Name Last Name Child #2 Hebrew Name:* Child #2 Date of Birth:* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child #2 Time of Birth:* 123456789101112 Hour001020304050 MinutesAMPM Grade (Entering into the 2025/2026 school year) Kindergarten 1st grade 2nd grade 3rd grade4th grade5th grade 6th grade 7th grade Program Selection:* "First Taste" Program (grades K & 1) Sunday’s, 9:30am - 12:00pm - $1050Hebrew School (grades 2-7) Sunday, 9:30am - 12:00pm & Wednesday 4:30pm - 6:00pm - $1400 Child #2 T-Shirt Size:* Add another child Child #3 Name:* First Name Last Name Child #3 Hebrew Name:* Child #3 Date of Birth:* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child #3 Time of Birth:* 123456789101112 Hour001020304050 MinutesAMPM Grade (Entering into the 2025/2026 school year) Kindergarten 1st grade 2nd grade 3rd grade4th grade5th grade 6th grade 7th grade Program Selection:* "First Taste" Program (grades K & 1) Sunday’s, 9:30am - 12:00pm - $1050Hebrew School (grades 2-7) Sunday, 9:30am - 12:00pm & Wednesday 4:30pm - 6:00pm - $1400 Child #3 T-Shirt Size:* Add another child Child #4 Name:* First Name Last Name Child #4 Hebrew Name:* Child #4 Date of Birth:* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child #4 Time of Birth:* 123456789101112 Hour001020304050 MinutesAMPM Grade (Entering into the 2025/2026 school year) Kindergarten 1st grade 2nd grade 3rd grade4th grade5th grade 6th grade 7th grade Program Selection:* "First Taste" Program (grades K & 1) Sunday’s, 9:30am - 12:00pm - $1050Hebrew School (grades 2-7) Sunday, 9:30am - 12:00pm & Wednesday 4:30pm - 6:00pm - $1400 Child #4 T-Shirt Size:* Add another child Payment InfoAdditional Fees: $50 Registration Fee, per family $220 Security Fee, per family Additional Fees: $50 Registration Fee, per family$220 Security Fee, per family I would like to pay:* Full amount todayMonthly payments automatically deducted through April 1, 2026Other $ (Needs to be $250 minimum) and the balance will be paid monthly through April 1, 2027Please contact me in regard to a scholarship application. (Scholarships are available on a case-by-case basis.) If you are applying for a scholarship request please fill out the attached form. Our Financial advisory board will only consider scholarship requests if the scholarship form is filled out with all the information that is required. Click here to fill out the scholarship request form. Once done please come back to this page to finish your registration. I would like to kindly donate to the CHS Scholarship fund : $ Total $50.00 I would like to pay today:Full amount$250.00 minimum$ Payment Credit Card Check (Only if agreed on before filling in this form) / Mail-in Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration Year(available case-by-case)Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Terms of agreement * I agree that in the event of an emergency, Chabad Hebrew School has permission to arrange for any necessary first-aid or care by a licenced physician /first-aid worker.Chabad Hebrew school has permission to use my child’s photo in its publicity materials. Signature: We look forward to a wonderful year of learning and growth! Submit Should be Empty: This page uses TLS encryption to keep your data secure.