Hebrew School enrollment - Chabad of NW Seattle

HEBREW SCHOOL REGISTRATION
1. Student information
Child's Name*
First NameLast Name
Hebrew Name*
Birth Date*
MonthDayYear
Does your Child have any previous Jewish education? If yes please describe.*
What School does your child attend?*
Grade entering*
Have there been any conversions or adoptions in the family? If yes please explain.*
Additional notable Information
Parents Information
Parent 1 info-name*
First NameLast Name
Cell number*
Area CodePhone Number
Email address?*

Address*

Address if different

Marital status*
MarriedDivorcedSeprarated
Mother born Jewish*
YesConvertedNot Jewish
Converted by whom?
3. Emergency information
Emergency contact*
Phone number*
Relationship
Pediatrician
Phone number
Tuition fees (and how to save)
Tuition: $1,050
Early Bird special: $1,000 (expired)
Referrals: Save $100 for each family that signs up.
Late enrollment fee: $50 after September15th.
*Please note, that no one will be turned away due to lack of funds. Please contact the office to discuss any financial considerations.
Payment
Tuition Cost
$1100
Payment. Please let us know if you would like to pay via check.
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Please mail your check to Chabad of Ballard 357 N 77th St Seattle Wa 98103.
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HEBREW SCHOOL REGISTRATION