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General Information
Where did you hear about us
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Your local Chabad center
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Student's Information
Child's First Name
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Last Name
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Gender
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Male
Female
Birth Date
(MM/DD/YYYY)
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Approximate time of day when born and location of birth
Child's Current Grade
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Is your child ....
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existing student
new student
Parents Information
Father's First Name
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Mother's First Name
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Address
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City
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State
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ZIP
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Country
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Home Phone
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Father Cell
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Mother Cell
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Father's Email
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Mother's Email
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Father Jewish By?
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Birth
Conversion
Other
Conversion type:
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Orthodox
Reform
Conservative
Mother Jewish By?
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Birth
Conversion
Other
Conversion type:
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Orthodox
Reform
Conservative
Additional Information about your Child
This past year, was your child?
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Homeschooled
Hebrew Day School
Public School
If your child was in Day School what school was he/she attending?
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Which years did he/she attend this school?
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Which Jewish Community are you affiliated with?
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Why do you feel the online school would be the best fit for your child?
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Which subject/s would you like your child to learn in his class? We would like to accomodate if possible!
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Rate your Child
Where is your child holding in his/her Hebrew reading and Jewish Studies?
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Has he/she learned the Alef Bet? The Vowels? Can he/she read Hebrew? Has he/she begun learning Chumash? With Rashi? Please be as specific as possible.
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Indicate anything we need to know about your child?
If you child is attending public school or day school what time does he/she come home from school?
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Would you be interested in our Conversational Hebrew Class?
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