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Hebrew School Registration Form 2017-2018

Hebrew School Registration Form 2017-2018

Chabad Hebrew School Registration

We are currently accepting application forms for the 2017-2018 school year. Please fill out ALL fields of this form.
If you have any questions or concerns you'd like to discuss with us, please contact the Director Dina Krasnanski at: 514-342-1770.

Click Here to download a pdf and mail it in to our office:
Chabad Of The Town, Montreal • 4054 Rue Jean-Talon O • Montreal, QC H4P 1V5 • Canada

Please note that one registration form per child is needed.

Returning students should only fill out the fields that need updating.

View Hebrew School Photos

STUDENT INFORMATION
First Name   Last Name
Hebrew Name   D.O.B.
School Child Attends   Grade Entering
Previous Jewish Education Yes No   If yes - where?
Were there any conversions in the family? Yes No   If Yes - please name
Where was conversion performed? Synagogue Name:   Rabbi who officiated conversion

PARENT INFORMATION
Father's Name   Father's Hebrew Name
Father's Email   Father's Cell
Father's Work #      
         
Mother's Name   Mother's Hebrew Name
Mother's Email   Mother's Cell
Mother's Work #      
         
Address   Province
P.C.   Home Phone
 
ADDED INFORMATION

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.


Whom should be called in case of emergency?   Phone Relation

PAYMENT INFO
I choose to send my child/ren to:
Sunday School Program: $400/year
Second/third child is 10% off. Refer a new student and receive an additional 5% off. This includes all classroom, in school activities and snacks. All trips outside of school (1 – 3 per year) are extra.
Hebrew School to Go: $25/per weekly visit
Limited Spots available. Schedule & timing to be discussed.
 
PAYMENT:
Name on card   Card Type
Card Number   Exp. Date
CVV Code 3 digits on back of card   I prefer to send a check and will mail it to you.
Please charge my card in one full payment
Please charge my card in 4 installments: September, December, February & May

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