New Student Register - JewishGilbert.com

GILBERT HEBREW SCHOOL REGISTRATION
2022-2023 School Year
Thank you for choosing Gilbert Hebrew School for your child! All new families are required to participate in a Family Meeting prior to completing their registration. If you have not yet attended a Family Meeting, please email [email protected] to schedule your meeting.

Please note your registration is only complete after a confirmation email is sent to you. Feel free to email us at [email protected] or call 480-269-6680 with any questions you may have.
Child's Name*

First Name Last Name
Hebrew Name
Birth Date*

Month Day Year
Approximate Time of Birth

This info used to determine their Hebrew Birthday
Grade entering*
School*
Parents Information

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father's Name*

First Name Last Name
Father Cell*

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

First Name Last Name
Mother Cell*

Area Code Phone Number
Mother E-mail*
Employer
Position
Religious & Educational History
Previous Jewish Education
Does your child have any learning difficulties with general studies?*
If yes, please describe
Were there any conversions and/or adoptions in the family?*
If yes, please specify
Synagogue Affiliation
Medical Information
Up to Date with Vaccinations?*

Yes No
Are there any special medical, allergy or other information that I should be aware of?
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relation to Student*
City/Town*
Family Physician*
Phone Number*

Area Code Phone Number
Accident, Trip & Privacy Declaration:

Accident: As the parent or legal guardian of the above listed child, I authorize any adult acting on behalf of Gilbert Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Gilbert Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.

Trips & Outings: I hereby give permission for my child to attend and participate in all trips and outings organized as part of the program by Gilbert Hebrew School.

Privacy: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Gilbert Hebrew website or for promotion of our program. I give permission for our family contact information to be shared with other families.
Authorization*

Click to confirm consent
Parent Signature*
Payment
Hebrew School Tuition is $650.

Tuition fees include all books, art materials and trips. Synagogue membership is not required. Affiliated and non-affiliated are welcome.

A $50 non-refundable deposit per child is due with registration. The deposit will be applied to tuition.

$25 Early Bird Discount for registration received by June 24, 2022. 10% discount for additional children in same family.
Payment Plans

Plan A: Pay full Tuition by September 1st, which entitles a $30 discount off the family's total tuition fees. Plan B: Automatically charge credit card on the first of each month, September – May
Request for Scholarship

Due to the needs and limits of our family, we would like to request a scholarship. Scholarship requests will be reviewed and responded to within 3 weeks of submission.
Scholarship Amount:

Amount we are prepared to pay towards our child’s Hebrew school tuition
Tuition Deposit*

$50
Additional Payment Toward Tuition to be paid upon submission of form.

$
Total

$0.00

Payment*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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GILBERT HEBREW SCHOOL REGISTRATION

2022-2023 School Year

Parents Information

Religious & Educational History

Medical Information

Payment