Register

** Please Note - Acceptance to the school is pending approval following an interview with Mrs. Nechama Bergstein
Children Information
How many children are you registering?
Child 1 Name*

First Name Last Name
Child 1 Hebrew Name
Child 1 Birth Date

Month Day Year
Child 2 Name

First Name Last Name
Child 2 Hebrew Name
Child 2 Birth Date

Month Day Year
Child 3 Name

First Name Last Name
Child 3 Hebrew Name
Child 3 Birth Date

Month Day Year
Parents Information
Mother's Name

First Name Last Name
Mother's Hebrew Name
Mother is Jewish

By birth Convert Neither
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
Father's Name

First Name Last Name
Father's Hebrew Name
Father is Jewish

By birth Convert Neither
Father's Cell*

Area Code Phone Number
Father's E-mail*
Marital Status*
Have there been adoptions in the family, including grandparents?*

Yes No
If 'Yes', please explain
Have there been conversions in the family, including grandparents?*

Yes No
If 'Yes', please explain

Address*

Payment

$850 per child (5% discount applied for each sibling)
How many children are you registering?*
How would you like your balance to be charged?

Charge the full amount now Charge half now and the rest on 12/1 Charge Monthly
I'm aware that there are students on scholarships. Please put this additional amount towards the tuition of a fellow student in need.

$50 $250 $850

Payment Method*

Credit Card

Billing Address

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Educate Your Child... Educate a Generation

Children Information