Student/s Information

New or returning student? *

Returning student

New student

Hebrew Level *

Are you a new family in our area ? *

Yes

No

First Name *

Last Name *

Sex *

Date of Birth * +

Grade/Class *

Teacher?

Parent is a teacher in the school

Childcare/Public School as of September 2024 *

Special educational concerns ?

Known food allergies or medical concerns? *

Second child

2nd student

Registering 2nd student

New or returning student? *

Returning student

New student

Hebrew Level *

First Name *

Last Name *

Sex *

Date of Birth * +

Grade/Class *

Childcare/Public School as of September 2024 *

Special educational concerns ?

Known food allergies or other medical concerns? *

Third child

3rd student

Registering 3rd student

New or returning student? *

Returning student

New student

Hebrew Level *

First Name *

Last Name *

Sex *

Date of Birth * +

Grade/Class *

Childcare/Public School as of September 2024 *

Special educational concerns ?

Known food allergies or other medial concerns? *

Tuition and Donation

Scholarship information

I'm interested in donating

$100 donation

$200 donation

additional/other donation of

Donation *

Classes will be held on Mondays

Registration fee is $100 for each student and Tuition is $1,300

During online registration, you are charged with registration fees only

As in last year, we ask you to make a donation for the school according to your ability

Donations are important to the security of our school’s budget and allow for enriching the content provided

Donations are tax deductible - Tax ID 45-3245413

Scholarship - to apply for scholarship, see the link above

Registration and payment of registration fees are necessary to discuss the request for a scholarship

Household / Adult Contact

Guardian #1 First Name *

Guardian #1 Last Name *

Guardian #1 Email Address *

Guardian #1 Phone *

Guardian #2 First Name *

Guardian #2 Last Name *

Guardian #2 Email Address *

Guardian #2 Phone *

Address 1 *

Address 2

City *

State *

Zip *

Emergency Contact (not parents)

First Name *

Last Name *

Phone *

Relationship *

Medical Information

Physician Name *

Phone *

I hereby give consent to the administration of the Israeli Complemenrary School to take whatever medical measures they deem necessary for all my children registered above in the event of a medical emergency.

Medical Release Consent *

Yes

No

Date * +

Name *

Photo Release Form

I authorize the Israeli complementary School to have use, publish, and reproduce photographs, slides, moving pictures or video tapes of all my children mentioned in the participants, for its records, public relations efforts, newspapers, the school's website or other social media websites. No names will be disclosed.

Photo Release Consent *

Yes

No

Date * +

Name *

Payment

Registration payment must be given using Paypal or credit card. For paying using a credit card choose Paypal payment on the next page and follow the directions for credit card payment. Please select the appropriate option in the next page. After paying you can go back to get a receipt with all the values entered on the form.

Note: Your registration is not complete unless you finalize your payment

Current Total:

$0.00