Hebrew School Registration 2019 - 2020

2019 - 2020 School Year registration.
P lease fill out ALL fields of this form.

We are proud to announce that Hebrew School will be under the direction of Rabbi Adi and Malky Goodman. Feel free to contact them at [email protected] or [email protected] Looking forward to a great year in Hebrew School!

Hebrew School Sunday Mornings - 10:00am - 12:15pm
Ckids Club - About twice Monthly on a weeknight.

Classes will be located at the new Chabad of SW Broward campus.
Until the new campus will be available, our temporary location will be held at Chabad at Monterra

Hebrew School honors the family membership discounts for $100 monthly level members or above from
Chabad of SW Broward and Chabad at Monterra.

In order to receive a membership discount, please sign up prior to submitting the below registration form for your child(ren). .
Click on link below to access the Chabad membership link.

Chabad of SW Broward Membership Form | Chabad at Monterra Membership Form

Student Information - Child 1:

Full Name:*

First Name Last Name

Hebrew Name:

Birth Date & Time:*

Month Day Year

at Hour Minutes

School Name:*

Grade in Sept. 2019:*

Student Information - Child 2:

Full Name:*

First Name Last Name

Hebrew Name:

Birth Date & Time:*

Month Day Year

at Hour Minutes

School Name:*

Grade in Sept. 2019:*

Mother's Information:

Full Name:

First Name Last Name

Hebrew Name:

Address:

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

Home Phone Number:

Area Code Phone Number

Cell Phone Number:

Area Code Phone Number

Work Phone Number:

Area Code Phone Number

E-mail:

Father's Information:

Full Name:

First Name Last Name

Hebrew Name:

Address (if different)::

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

Home Phone Number (if different):

Area Code Phone Number

Cell Phone Number:

Area Code Phone Number

Work Phone Number:

Area Code Phone Number

E-mail:

Family Profile:

Child Resides With:*

Is the natural mother of the child Jewish?*

Yes No

Is the mother's mother Jewish?*

Yes No

Is the natural father of the child Jewish?*

Yes No

Is the father's mother Jewish?*

Yes No

Please explain any conversions or adoptions in the family:

Please let us know where and for how long your child has previously attended Hebrew School:

Please specify any learning difficulties your child may have:

Special Instructions (allergies, etc.):

Emergency Contact (besides parent) Name & Phone Number:

Person(s) authorized to pick up my child(ren):

What are some of the goals you hope your child will achieve through attending the Chabad Heberw School?

How did you hear about Chabad Hebrew School?

Tuition:

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