JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Nageela Hebrew School Online Registration
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student's Information
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Hebrew Name
(Please leave blank if you aren't sure)
Your answer
Date of Birth
*
Your answer
Gender
*
Choose
Male
Femlae
Address Line 1
*
Your answer
Address Line 2
Your answer
City, State
Your answer
Zip Code
*
Your answer
Primary Phone
*
Your answer
Primary School
Your answer
Grade entering (2018-2019 school year)
Choose
K
1
2
3
4
5
6
7
8
9
Special Educational or Medical Needs
Please let us know of any conditions that might affect health or school participation
Your answer
Previous Jewish Education
Please describe previous Jewish Education, if any
Your answer
Primary reason for joining
*
Choose
Want to have a bar/ bat mitzvah
Just like to learn
Want to be more Jewishly involved
Other
What would you like to gain
What benefits are you looking for from Nageela Hebrew School?
Your answer
Family Information
Father's Name
*
Your answer
Father's Phone #
*
Your answer
Father's Email Address
*
Your answer
Father's Jewish Status
*
Born Jewish
Converted
Not Jewish
Who officiated the conversion, and when did it take place?
Please include name of Rabbi, Temple and date
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Community Kollel of Greater Las Vegas.
Report Abuse
Forms
