Chaya Esther Hebrew School Application 2020-2021/5781

* Partnership Status

* Number of Children Applying

* Child 1 Full Name

Child 1 Jewish Name

Please Select OneMaleFemale

* Date Of Birth

* Grade Entering Sept. 2020

* Child 2 Full Name

Child 2 Jewish Name

Please Select OneMaleFemale

* Date Of Birth

* Grade Entering Sept. 2020

* Child 3 Full Name

Child 3 Jewish Name

Please Select OneMaleFemale

* Date Of Birth

* Grade Entering Sept. 2020

* Street Address

* City

* State

* Zip Code

* Home Phone

* Marital Status of Parents

* Child lives with

* Father's Full Name

* Is the Father Jewish?

Please Select OneJewishNot Jewish

Father's Jewish Name

* Father's DOB

Father's Work Phone

* Father's Cell

* Father's Email

* Mother's Full Name

Is the Mother Jewish?

Please Select OneJewishNot Jewish

Mother's Jewish Name

* Mother's DOB

Mother's Work Phone

* Mother's Cell

* Mother's Email

* Synagogue Affiliation

* Day School

* How did you hear about us?

* Does your child read or speak Hebrew?

Please Select OneYesNo

* Has your child previously attended Hebrew School?

Please Select OneYesNo

* Which Hebrew School did they attend?

* Does your child have any learning difficulties with general studies?

Please Select OneYesNo

If yes, please describe

* Were there any conversions and/or adoptions in the family?

Please Select OneYesNo

* If yes, who?

Is anyone in the family a Kohen or Levi?

Please Select OneYesNo

If yes, who?

* Does your child have any allergies?

Please Select OneYesNo

* If yes, please describe

* Does your child have any special needs, medication, or anything you feel we should know about?

Please Select OneYesNo

If yes, please describe

* Emergency Contact Name

* Relationship to Child

* Phone 1

Phone 2

* Family Physician Name

* Phone

Please List Additional Children Not Attending Hebrew School

Please include each Child's Full Name, Jewish Name, and DOB

TUITION:

Tuition is $900 for the year per child, plus a $75 Security fee per child
(includes all books and supplies).

Discounts:
$50 returning student discount
$75 partner discount (per child)
$50 sibling discount for 2nd child
$50 pay in full discount
$50 Refer a new family discount

You may choose to pay in full now and receive $50 discount, or pay in 4 installments; at registration, Nov 1, Jan.1, March 1.

There will be no refunds for any payments made.

* Payment Information:

Please Select OnePay in Full discount ($50 discount)Tuition to be paid in 4 installments. The first installment to be paid now, the remainder 3 installments will be charged on the first of November, January & March

* Payment Information:

Please Select OneFull payment charged now - ($50 discount)Tuition to be paid in 4 installments. The first installment to be paid now, the remaining 3 installments will be charged on the first of November, January & March

Partner Discount Applied - $75 off

* Payment Information:

Please Select OneFull payment charged now ($100 discount)Tuition to be paid in 4 installments with the first payment charged at checkout and the remaining 3 installments will be charged on the 1st of November, January & March

Sibling Discount Applied - $50 off additional child

* Payment Information:

Partner Discount Applied - $75 off

Sibling Discount Applied - $50 off additional child

Payment information

* Credit Card Number For Tuition Installments

This card will be used for your 4 tuition installments (At checkout and on the first of November, January & March).

* Name on Card

* Expiration Date

* Security Code

* Billing Zip:

Total Charge:

CHAYA ESTHER HEBREW SCHOOL AGREEMENT

Hours: Sunday, 10:00 am – 12:00 pm

Tuition Includes

All workbooks & supplies

Tuition Notices

To register, a completed registration form is necessary along with the first installment per child
If full payment is not received with registration form, tuition balance will be charged in 3 additional installments on the first of November, January and March
There is no credit for absences or days missed.

Activities

My child has permission to engage in all programs and activities. Additionally, permission is hereby granted to Chaya Esther Hebrew School to take my child on trips outside of school as part of the regular school program.

Images

Permission is hereby granted to Chaya Esther Hebrew School to use digital, photographic, video and audio images and likenesses of my child/ren in promoting Hebrew School and other ventures associated with Center for Jewish Life.

Medical Release

In the event that I cannot be contacted in an emergency or situation warranting medical attention, I hereby grant permission to Chaya Esther Hebrew School to bring my child/ren to the emergency room and/or give permission to the medical personnel selected by the Hebrew School director to provide routine healthcare.

Dismissal of Student

Chaya Esther Hebrew School reserves the right to dismiss any student whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interest of the school, the student or their fellow students. In these instances, no refunds will be issued.

* I have read and accepted all terms and conditions set forth on this application.

I have read and accepted all terms and conditions set forth on this application.

* Parent/Guardian Signature

Connect With CJL

Center for Jewish Life • 176 Route 79 North Marlboro, NJ 07746 • Phone: 732-316-7600 • Fax: 732-316-0300 • info@cjlnj.com