We are currently accepting application forms for the 2014-2015 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.

We look forward to a wonderful year of learning and growth.  

Student Information
Child 1:      
Child's Name Hebrew Name
Date of Birth School
Grade Entering Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No Where?
       
Child 2: (if applicable)    
Child's Name Hebrew School
Date of Birth School
Grade Entering Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education? Yes No Where?
       
Is the natural mother and maternal grandmother of the child Jewish? Yes No
Have there been any conversions or adoptions in the family? If Yes, please explain.

 
Parent Information
Father's Name Email
Work Phone Cell Phone
Mother's Name Email
Work Phone Cell Phone
Address City
State Zip
 
Emergency Informaion
Emergency Contact 1 Phone
Emergency Contact 2 Phone
 
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.
 
 
 
Payment Information
Chabad Hebrew School Tuition for the complete year is $750 (per child). 
There is also a $50 non-refundable registration fee which is separate from the tuition fee and is due immediately upon registration.

DISCOUNTS:
FULL PAYMENT IN ADVANCE: Tuition PAID IN FULL before September will receive $25 off.
SIBLING DISCOUNT: We offer a $25 discount on the tuition for each additional child in a family
REFERRAL: We offer a $50 discount off of tuition when a family refers another student to the Chabad Hebrew School
Please select payment plan:
Plan A - Prepayment in full before September. This option is eligible for a discount. See above.
Plan B - Payment of 2/3 of tuition before September, 1/3 by January 10.
Plan C - Please call me. I'd like to discuss tuition over the phone or in person 
 
At this time, I will be paying a total of $ which includes the $50 registration fee plus $ towards my tuition.
Payment Method   Checks can be mailed to 159 Boden Lane, Natick, MA 01760
Card Number Billing Address
Expiration CVV Code What's This?
Comments    
 
 
Terms of Enrollment

As the parent(s) or legal guardian of the above child(ren), I/we authorize any adult acting on behalf of 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, Chabad 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 Chabad Hebrew School activities and that these pictures may be used for marketing purposes.
I Accept Name: Initials:
 

 We look forward to a wonderful year of learning and growth!