NACHAS 2019-2020 Online Registration Form
Untitled Title
Student Information
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Hebrew Name
Your answer
Birthdate *
MM
/
DD
/
YYYY
Current Grade in School *
Congregation Membership (Check all that apply) *
Required
Parent Information
If you're registering multiple children, you don't have to fill out all the parent information each time. Please enter it for one child and then note the names of your other children in the field below. That way, we can cut and paste the information easily and save you time!
Please list the names of all the students you are registering for school this year.
Your answer
1st Parent Name *
Your answer
Address *
Your answer
1st Parent Home Phone # *
Your answer
1st Parent Cell Phone #
Your answer
1st Parent Email Address
Your answer
Can we send you a text message when there's important NACHAS information to share? *
2nd Parent Name
Your answer
2nd Parent Address (if different)
Your answer
2nd Parent Home Phone #
Please enter the best number for principals & teachers to contact you
Your answer
2nd Parent Cell Phone #
Your answer
Can we send you a text message when there's important NACHAS information to share?
2nd Parent Email Address
We'll use this address to send updates and school information. Please make sure it's an email address you check regularly!
Your answer
Allergy & Health Information
Does the student have any food allergies? If so, please list them.
Your answer
Is the student allergic to bee stings or have any other non-food allergies we should know about? If so, please specify.
Your answer
Emergency Contact
If there's a problem and we can't reach you, who can we call?
Name *
Your answer
Please provide contact phone numbers for your emergency contact person. *
Your answer
Relationship to the student
Tuition Information
$235 per child for those children of Member families
- There is a $10 discount for each additional child enrolled.

$750 per child for those children of non-Member families

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