Sept. 2019 through May 2020

Contact the Director at: RabbiMendel@ChabadFortLee.com

Register Now!

We are currently accepting application forms for the 2019-2020 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
Time of Birth AM PM
School Attending
Grade Entering
(Sep. 2019)
Previous Jewish Education Yes No
Where?
Hebrew Reading Proficiency None Somewhat Well
Child 2:
Child's Name
Hebrew Name
Date of Birth
Time of Birth AM PM
School Attending
Grade Entering
(Sep. 2019)
Previous Jewish Education Yes No
Where?
Hebrew Reading Proficiency None Somewhat Well
Child 3:
Child's Name
Hebrew Name
Date of Birth
Time of Birth AM PM
School Attending
Grade Entering
(Sep. 2019)
Previous Jewish Education Yes No
Where?
Hebrew Reading Proficiency None Somewhat Well
Parent Information
Marital Status
Child Lives With
Is your child's natural mother and maternal grandmother Jewish? Yes No
 
Father
First Name
Last Name
Work Phone
Cell Phone
Occupation
Email
 
Mother
First Name
Last Name
Work Phone
Cell Phone
Occupation
Email
 
Home
Address
City
State / Zip
Home Phone
Have there been any conversions or adoptions in the family? Yes No
Please provide more context
Main Expectation:
Primary Mail Correspondence:
General Information
Other person authorized to pick up child
Name
Cell
Relation
Parent Volunteers
I am available to volunteer as a chaperone for local field trips, assist in special programming or have special interests or skills I would like to bring into the classroom:
Comments
Emergency Information
Emergency Contact 1
Phone
Emergency Contact 2
Phone
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? Yes No
Please describe them and indicate special precautions or care needed.
As the parent(s) or legal guardian, 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 attend all field trips and outings sponsored by Chabad Hebrew School.
Payment Information
 

If you are unable to pay please call our office for a scholarship. We will not turn a child away because of a lack of funds.

Referred by:
Refer a friend and receive a discount on your family tuition.

I allow pictures to be taken of my child for school use.

Payment Method

• Make checks payable to “Chabad of Fort Lee” and mail to “808 Abbott Blvd. Fort Lee, NJ 07024”.

Card Number
Billing Address
Expiration
CVV Code What's This?