HEBREW SCHOOL ONLINE REGISTRATION

We are currently accepting application forms for the 2018-19 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 us at Chanchie@ChabadofNH.com or call 603.647.0204.

We require a $50 deposit per family due at the time of registration.

STUDENT INFORMATION
First Name   Last Name
Hebrew Name   D.O.B.
School   Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes  No If yes - where? 
PARENT INFORMATION
Father's Name   Father's Cell
Mother's Name   Mother's Cell
Address   City, State, Zip
City State Zip
Home Phone   Mother's email   Father's email  
 

 

Please fill in for each of the following family members,  yes or no if they are Jewish: 
Father  Mother 
Paternal Grandmother  Paternal Grandfather  Maternal Grandmother  Maternal Grandfather 

Were there any conversions or adoptions in the family? Please specify  

 

EMERGENCY INFORMATION
Emergency Contact 1   Phone
Emergency Contact 2   Phone

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


As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the Chabad Hebrew School 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, Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. 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 Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept 

Name:  Initials:

PAYMENT OPTIONS

•Tuition for the coming year is $675 plus a $25 book fee.
We will never turn anyone away for financial reasons, please inquire about financial assistance- Chanchie@ChabadofNH.com

 I understand that a $50 deposit ONLY, that will be applied towards tuition, will be charged to my credit card along with my form submission.

I will mail in my deposit ASAP. 
• The remaining tuition balance can be paid by Credit Card, or mailed to Chabad Hebrew School • 1234 River Rd, Manchester, NH 03104

Name on card   Card Type
Charge Amnt.  enter $50 deposit or you will be charged the amount you enter here   Card Number
Exp. Date   CVV Code 3 digits on back of card
I would like to pay

 Please check box with your choice for method of payment. 

Prepayment in full in September.

Pay ½ of tuition in September, and ½ by January 15.

Total cost split by 8 equal monthly payments.

Method of payment:

Check

Credit Card

 Invoice me

Special Arrangements - I will be in touch with Rabbi Krinsky 603.647.0204

    

 

 

  • Our program does not require any family membership at a synagogue and all students and their families are welcome to attend services at Chabad at no additional cost.· Although our programs are open to families of all backgrounds and affiliations, and no family will be denied because of inability to pay, and we don't require separate membership for our synagogue, our synagogue is traditional and life cycle events, such as Bar and Bat Mitzvah, can only be celebrated by children of a Jewish mother or those converted under Halachic auspices. 
     We look forward to a wonderful year of learning and growth!