Printed fromJewishCulverCity.com

Hebrew School

WHERE IT'S FUN TO LEARN

AND WE LEARN TO HAVE FUN!

ב"ה

Registration

Student Information
Full Name*
First NameLast Name
Hebrew Name
First NameLast Name
Birth Date*
MonthDayYear
Grade entering*
Additional notable InformationPlease let us know if there are any allergies or other important information we need to be aware of.
Parents Information
E-mail*

Address*

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

Father's Name*
First NameLast Name
Father's Cell*
Area CodePhone Number
Mother's Name*
First NameLast Name
Mother's Cell*
Emergency Contact*
Mother Jewish by:*
BirthChoice
I am willing to assist in school activities, please contact me
Payment
Registration Fee*Per Child: $75/Month per child
Yes, I'd like to make this a monthly recurring payment.
Optional
$54$180$360
Total
$0.00

Payment

Credit Card Paypal

Postal / Zip Code

Country

Should be Empty:

This page uses TLS encryption to keep your data secure.

CURRICULUM

REGISTRATION