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JUDA Registration
Please verify reCaptcha before submitting the form.
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
Please Select One
Male
Female
*
Grade Entering
Please Select One
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
*
My Child
Please Select One
Does not read Hebrew
Recognizes letters of the Alef-Bet
Can read Hebrew slowly
Can read Hebrew very well
*
My child's knowledge of basic Judaism:
Please Select One
Good
Fair
Poor
*
Does your child have any physical/mental conditions we should be aware of?
*
Are the child's biological parents Jewish by birth?
Please Select One
Yes
No
If no, please explain:
*
Have there been any conversions or adoptions in your family?
Please Select One
Yes
No
If yes, please explain:
*
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
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 One
Non-Member Tuition
CBI Member Tuition
Tuition Total:
Mon, June 5 2023
16 Sivan 5783
Mon, June 5 2023 16 Sivan 5783