We are currently accepting application forms for the 2026-2027 school year. Please fill out ALL necessary fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

This form is for Children from pre-k until 3rd Grade. (Children entering 3rd grade 2026 Should use this form)

We look forward to a wonderful year of learning and growth.

Student Profile

 Tuesdays 4:15 PM - 6:15 PM

Student 1 Student 2 Student 3
Student's Full Name Student's Full Name Student's Full Name
Hebrew Name Hebrew Name Hebrew Name
Date of Birth Date of Birth Date of Birth
Gender Gender Gender
School Attending School Attending School Attending
Entering Grade Entering Grade Entering Grade
Hebrew Reading Proficiency Hebrew Reading Proficiency Hebrew Reading Proficiency
Previous Jewish Education Previous Jewish Education Previous Jewish Education
Where? Where? Where?
Was child's biological mother born Jewish?* Were grandmothers born Jewish?*  Any conversions/adoptions in family?*   If Yes please describe:  (If yes, please email certificae to be cleared by the RCA)
Parent Information
Home Phone
Father's Name
Father's Cell
Father's Email Address
Mother's Name
Mother's Cell
Mother's Email
Address
City
State
Zip
Marital Status Other/explain:
Emergency Information
Emergency Contact 1
Phone
Emergency Contact 2
Phone
Doctor
Address
Phone

CONFIDENTIAL: Does your child receive additional resources in school? (Ie. ADD / ADHD).

Does your child have allergies or other medical condition we should be aware of?

Please describe above and indicate special precautions or care needed.

Payment Information
Hebrew School Annual Tuition:
1 Child: $1,900 tuition (includes book fee, supplies, and early dinner) +$400 Security fee = Total $2,300
2 Children: $3,800 tuition (includes book fee, supplies, and early dinner)+ $800 Security fee = Total $4,600
($350 per child is a non-refundable registration fee, included in the total.)
Select Amount*
Payment Method

As the parent(s) or legal guardian of the above child, I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.

*

Name: * Initials:*

We look forward to a wonderful year of learning and growth!