Welcome to our online registration form.

Registration for 2018-19 school year NOW OPEN!

Current students register for next year here 

Basic Information:  

Child's First Name  Last Name     

Hebrew Name

Gender Male Female 

Date of Birth Date of Birth (Hebrew)

Residence Street Address

City State Zip

Residence Phone

Contact information:

Mother's Name  Hebrew Name 


Cellphone  E-mail  


Work Phone  Employer 

Father's Name  Hebrew Name 


Cellphone  E-mail 


Work Phone  Employer 

Are there any conversions in the family? Yes No 
If yes please explain: 

Register for School Year 2018-19

Class Options:

 

Hours: Core Program (8:30-12:30)

           Full Day (8:30-2:30) 

            Full Day with Aftercare (8:30-4 PM)

I will also be filling out a scholarship form

Health information:

 Please check here if there is ANY ALLERGY or medical condition that will need to be accommodated at school. (This will be followed up a meeting on our health and safety protocol) 

Emergency Contact Information:

1.Name: Relation: Phone:

2.Name: Relation: Phone:

Registration Fee:

Registration fee of $100 must be paid at time of registration for your child to be enrolled.

Payment Type:

Name on Card: Card No:

CVV: Expiration Date:

Tuition is to be paid through FACTS Tuition Payment Plan. New parents sign up online here. For parents who are re-registering and already are on FACTS, your information will be used again automatically. Be sure to contact the office with any bank account or date changes to avoid any bounced check fees.

Parent Signature Date


Email Address (For confirmation)