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Please fill out ALL fields of this form.

If you have any questions or concerns you'd like to discuss, please contact us.
We look forward to a wonderful year of learning and growth.
One registration form is needed per child.

* First Name

* Last Name

Hebrew Name

* Gender

* Grade Entering

* My Child

Please Select OneDoes not read HebrewRecognizes letters of the Alef-BetCan read Hebrew slowlyCan read Hebrew very well

* My child's knowledge of basic Judaism:

Please Select OneGoodFairPoor

* Does your child have any physical/mental conditions we should be aware of?

* Are the child's biological parents Jewish by birth?

Please Select OneYesNo

If no, please explain:

* Have there been any conversions or adoptions in your family?

Please Select OneYesNo

If yes, please explain:

* Address

* City

* State

* Zip Code

* Father's First Name

* Last Name

* Phone Number

* Email

* Mother's First Name

* Last Name

* Phone Number

* Email

* In case of an emergency and the parents cannot be contacted, please contact:

* Phone Number

* Relationship

Tuition - $900.00
Registration - $50.00
Book Fee - $50.00

*Members of Congregation Beth Israel receive 10% off JUDA Tuition

* Tuition Type

Please Select OneNon-Member TuitionCBI Member TuitionNon-Member Prorated Tution

Tuition Total:

Fri, April 26 2024 18 Nisan 5784

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