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Hebrew School registration form
      
Our curriculum offers beginner Hebrew reading and language, Jewish history, Holidys, Prayer, and Jewish life. Our stimulating hands-on learning style will allow the children to experience this in a creative and educational way.

Hours: Wednesday 4- 6:00 PM
Location: Congregation Beth Ephraim/ Maplewood Jewish Center
113 Parker Ave (parking allowed on Burr Road)

Tuition: $550 members/ $750 non members (10% off 2nd child enrollment)
In full, on or before September 15 2015
Two payments dated September, 2015 and January 15, 2016

Child Information:  
Child's Name:
Hebrew/Jewish Name:
Age and grade (as of 9-01-15 must be five years of age)
Date of birth
Prior Hebrew Education


Second Child:  
Child's Name:
Hebrew/Jewish Name:
Age and grade (as of 9-01-15 must be five years of age)
Date of birth
Prior Hebrew Education


Does your child recognize letters of the Aleph- Bet: Yes No

Does your child have any learning difficulties with general studies?

Yes  No

Please explain

What school does your child attend?

Family info

Family name

Parent/ Guardian Name

Hebrew name of parents

Address

City , NJ Zip Phone: Home

Work Cell

Occupation:

E-mail Do you check it often? Yes No


Medical Information

Are there any medical conditions/allergies or pertinent information regarding your child, which we should be aware of?

Child's Doctor's Name:

Doctor's Phone #

Emergency Contact Information

Name

Phone Relationship

I hereby permit my child/ren to participate in all school activities and join in the school trips on and beyond school properties. In case of emergency, I hereby authorize the school to have my child taken care of by a physician in any way the situation may call for. I hereby agree to pay the yearly tuition fees.

Parents Signature

Date

Please do not include my in the school directory

Please do not publish any photographs of my child


*Type the code you see in the picture below.(Letters are not case-sensitive)
     
 

 


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A Project of Congregation Beth Ephraim-Maplewood Jewish Center
The Charles Kimmel Building
113 Parker Avenue, Maplewood NJ 07040
Email: admin@maplewoodjewishcenter.org

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