Chaya Esther Hebrew School Application 2020-2021/5781 - Returning Student - Form

* 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

* Street Address

* City

* State

* Zip Code

* Father's Email

* Mother's Email

Please fill in any new or updated information below.

Leave blank if same as last year

Home Phone

Father's Cell

Mother's Cell

Father's Email

Mother's Email

Marital Status of Parents

Child Lives With

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

Please Select OneYesNo

If yes, who?

Emergency Contact Name

Relationship to Child

Phone 1

Phone 2

Family Physician Name

Phone

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

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 (per child)
$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 ($50 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

Please Select OneFull payment charged now ($50 discount)Tuition to be paid in 4 installments with first installment charged at checkout. Remaining 3 installments will be charged on the 1st of November, January & MarchReturning Student Discount applied - $50 off

* Payment information

Please Select OneFull payment charged now ($100 discount)Tuition to be pad in 4 installments with the first payment charged at checkout and the remaining 3 installments will be charged on the 1st of November, January & MarchReturning Student Discount Applied - $50 off

Sibling Discount Applied - $50 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 & MarchPartner Discount Applied - $75 off

Returning Student Discount Applied - $50 off

Sibling Discount Applied - $50 off

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

Chaya Esther Hebrew School Application 2020-2021/5781 - Returning Student

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