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Programs Hebrew School

Hebrew School Registration 2022-2023

Child 1 Information
Full Name*

First Name Last Name
Hebrew Name*
Birth Date* Help us find out your child's Hebrew birthday

Month Day Year
School*
Grade Entering*
Student's Jewish Knowledge
Additional Notable Information Please let us know of any other important information that you would like us to be aware of.
Would you like to register another child?

Yes
Full Name

First Name Last Name
Hebrew Name
Birth Date Help us find out your child's Hebrew birthday

Month Day Year
School
Grade Entering
Student's Jewish Knowledge
Additional Notable Information Any other important information that you would like us to be aware of.
Parent Information
Returning Parents

Yes
Father's Name*

First Name Last Name
Father's Hebrew Name
Father's Cell*

Area Code Phone Number
Father's E-mail*
Father's Ocupation
Mother's Name*

First Name Last Name
Mother's Hebrew Name
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
Mother's Ocupation
Mother is Jewish by*

BirthChoiceNot Jewish

Home Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number

Area Code Phone Number
Is there any conversion or adoption in the family?*
If yes, please elaborate. (all information will be kept confidential)
Voluntering*

I would like to get involved in Hebrew School activities.I am not able to get involved in Hebrew School activities
Grandparents' Information
Paternal Grandfather*

First Name Last Name
Hebrew Name
Paternal Grandmother*

First Name Last Name
Hebrew Name
Maternal Grandfather*

First Name Last Name
Hebrew Name
Maternal Grandmother*

First Name Last Name
Hebrew Name
Emergency Information
Emergency Contact*

First Name Last Name
Relationship*
Phone Number*

Area Code Phone Number
Please list any allergies or medications that the child is taking*
Doctor*

First Name Last Name

Doctor's Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Doctor's Phone Number*

Area Code Phone Number
Medical Insurance*
Policy Number*
Security We will be having a designated security guard at the door of the synagogue from drop-off until dismissal. The security fee is $150 per family.

$150$0
Payment Due to the demand of Aleph Hebrew School and limited spots available, we are taking a deposit to reserve each student’s space at Hebrew School. The deposit will be refunded to students who complete the entire year at Hebrew School. (one deposit per family)

$500$0
I would like to make a donation for the Hebrew School Aleph Hebrew School is made possible by the support of the parents and alumni. Please consider the opportunity of donating

180 - Sponsor one class for one week360 - Sponsor one week of Hebrew School1000 - Sponsor a Hebrew School holiday event5000 - Sponsor a student for the year
I would like to make the above donation a monthly recurring payment If so, the monthly recurring payment will be only for the amount above, (and not for the security and registration fee)

Yes

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Authorization
I give permission to Aleph Hebrew School at MSC, and those authorized by Manhattan Sepharadic Congregation and Aleph Learning Center, to take photographs and to make recordings of my children and my family, and to use them in original or modified form in all media now or hereafter known, with or without my name or information about me, for the promotion, public education, and/or fundraising activities of Aleph Learning Center and/or Manhattan Sepharadic Congregation.
As the parent(s) or legal guardian I/we authorize any adult acting on behalf of the Hebrew After-School Program at MSC to hospitalize or secure treatment for my child. I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, the Hebrew After-School Program personnel will try, but are not required, to communicate with me prior to such treatment.
*

I authorize all that is written above
Signature* Full name
Thank you for applying! Please note that all applications will be reviewed and acceptance is only confirmed after receiving an acceptance letter.
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