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JOS Hebrew School
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REGISTRATION FORM
General Information
Where did you hear about us
Please select...
Your local Chabad center
Google search
Friend
Facebook
Military Chaplain
Shluchim Office
Other
Name:
Which year are you registering for?
*
Please select...
2020-2021
2021-2022
Student's Information
Child's First Name
*
Hebrew First Name
Last Name
*
Nickname
Gender
*
Male
Female
Birth Date
(MM/DD/YYYY)
*
Approximate time of day when born and location of birth
Child's Current Grade
*
Is your child ....
*
existing student
new student
Parents Information
Father's First Name
*
Mother's First Name
*
Address
*
City
*
State
*
ZIP
*
Country
*
Home Phone
*
Father Cell
*
Mother Cell
*
Father's Email
*
Mother's Email
*
Father Jewish By?
*
Birth
Conversion
Other
Conversion type:
Please select...
Orthodox
Reform
Conservative
Mother Jewish By?
*
Birth
Conversion
Other
Conversion type:
Please select...
Orthodox
Reform
Conservative
Family Information
Paternal Grandfather
*
Jewish
Converted
Other
Conversion type:
Please select...
Orthodox
Reform
Conservative
Paternal Grandmother
*
Jewish
Converted
Other
Conversion type:
Please select...
Orthodox
Reform
Conservative
Maternal Grandfather
*
Jewish
Converted
Other
Conversion type:
Please select...
Orthodox
Reform
Conservative
Maternal Grandmother
*
Jewish
Converted
Other
Conversion type:
Please select...
Orthodox
Reform
Conservative
Is your child adopted?
*
Yes
No
Is the birth mother jewish from birth?
Yes
No
Converted
Additional Information about your Child
Briefly describe your Jewish life at home.
Are you currently affiliated with a Jewish community?
*
(Shul, Temple, Synagogue, JCC, other Hebrew School, Chabad, etc.)
Does your child currently receive any other Jewish education? Please elaborate.
What are your long term educational plans? Is this a COVID related registration or are you looking to homeschool in general?
*
How many years of formal Jewish studies has your child received? Where?
*
Tell us about your Child
Does he/she know the Hebrew alphabet?
*
Beginner
Intermediate
Advanced
Can your child read simple Hebrew words?
*
Beginner
Intermediate
Advanced
Please indicate anything you feel we need to know about your child.
What day of the week works out best for your child?
*
What time works out best for your child?
*
* = Required Fields
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