Jewish Enrichment Program Registration

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Please fill out this form as an initial registration for the Jewish Enrichment Program.

Confirmation of acceptance will be acknowledged only after this registration form is
reviewed and an acceptance letter is received.

Student Information

Male Female

Does you child read basic Hebrew?
None Somewhat Well

Does your child speak/understand Hebrew? None Somewhat Well

What school does your child attend? Grade entering:
Are the natural mother and father of the child Jewish? Mother ____ Father _____  If not,

please explain ________________________________________________________________________________
Were there any conversions or adoptions in your family? Yes No
If yes, please describe:

Is child's maternal grandmother Jewish? Yes No


Have there been any conversions or adoptions in maternal grandmother's family? Yes No

If yes, please explain ___________________________________________________________________________

Any considerations, such as learning disorder or difficulty, the school should be aware of?


Parent Information


Emergency Contact Information
Please list two contacts to be used in case of emergencies (other than your home and business numbers).

Please send a copy of your insurance card for our files.

Up to date with vaccinations? Yes No Date of last tetanus shot:

Accept Do Not Accept
Initial here:

Tuition Agreement

The following is a tuition agreement for the Jewish Enrichment Program. The agreement explains the tuition fees, payments plans and refund policies. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes.

Tuition for Jewish Enrichment Program is $600 per year per child (includes all books and supplies). Registration fee: $50.


Sign up for 2023-2024 by May 21, 2023 and get $50 off per registration!    

Discounts: There is a 5% discount off of the regular tuition for each additional child of the same family. There is also a 5% additional discount off your total tuition for each child of another family you successfully introduce to the Jewish Enrichment Program.

You may choose from the following payment methods:
PLAN A: You may pay the entire amount in full with a check, cash or credit card.

PLAN B: You may pay the annual tuition on a monthly basis by submitting one (1) check for $50 and eight (8) checks for $75 each, dated October through May. All checks must be submitted before the first day of Sep.

PLAN C: You may use your credit card to pay the tuition on a monthly basis. Your credit card will be billed $50 upon registration, and then $75 every first of the month October through May. To do so please include your credit card number and expiration date at the bottom of this page.


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Your FULL name here:

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Check or Card No.

Check Date or Card Expiration: mm/yyyy /

I heard about the Jewish Enrichment Program from: