Hebrew School Registration for new students

HEBREW SCHOOL REGISTRATION FORM

We are currently accepting application forms for the 2023-2024 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.

Confirmation of acceptance will be acknowledged only after this registration form is reviewed and an acceptance letter is received.
Student Information
Student 1 Name*
First Name Last Name
Student 1 Hebrew Name
Student 1: Birth Date*

Month Day Year
Student 1: Time of birth

Day timeNight time
Student 2 Name
First Name Last Name
Student 2 Hebrew Name
Student 2:Birth Date

Month Day Year
Student 2: Time of birth

Day timeNight time
Student #3 Name
First Name Last Name
Student 3 Birth Date

Month Day Year
Student 3: Time of birth

Day timeNight time
Parent Information
Parents
Dad Mom

Address

Home Phone Number

Area Code Phone Number
Dad Mobile Number

Area Code Phone Number
Dad E-mail
Mom Phone Number

Area Code Phone Number
Mom E-mail
I would like to receive news and updates by email
Family Information
Are there any conversion in the family?*

NoYes
Who converted?

FatherMotherPaternal GrandmotherMaternal Grandmother
Please explain
Please click here to become a member and join the Chabad of Pembroke Pines family.
Select amount of children*
Hebrew School Scholarship Program
Total

$0.00

Payment

Credit Card Bring/Mail a check

Postal / Zip Code

Country

In these unstable times of the Covid pandemic, Chabad has lowered the price of Hebrew School tuition and is offering a payment plan.
Please choose an option below that best suits your family's needs.
Please consider sponsoring a child's tuition as well.
How would you like to pay?

One payment of $360Two payments of $180Three payments of $120
* A 3% surcharge will be added to all credit card payments.
Should be Empty:

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