Hebrew School Registration

Address*

Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Parents Information
Father's Name*
First Name Last Name
Father's Cell*

Area Code Phone Number
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother Jewish by:*

BirthChoice
Mother's Cell*

Area Code Phone Number
E-mail*
Best way to send Hebrew School updates:*

Cell PhoneEmailHandout
Payment
Registration Fee for 26/27 School Year

$850
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Once we receive your completed form, our team will review it and follow up with you shortly. Please note that acceptance is based on availability, as spots are limited. We’ll notify you as soon as a decision has been made.
I would like to receive news and updates from Chabad of South Bay Long Island by email. I understand that information I provide to Chabad of South Bay Long Island will be used according to its Privacy Policy and I can unsubscribe at any time.
Should be Empty:

This page uses TLS encryption to keep your data secure.