Torah Lishmah Community 2017-18 • New Student Registration
Please complete the registration below by May 1, 2017 in order for us to prepare for the upcoming school year.
Email address
Family Name
Please use the name you would like listed in our school directory
Your answer
Can we include your information in our school directory?
This will be distributed to school families only
Required
Please fill out the information below for Child #1
Name
Your answer
Hebrew Name
Your answer
Grade and School (include School District)
Your answer
Birthdate
Your answer
Please fill out the information below for Child #2
Name
Your answer
Hebrew Name
Your answer
Grade and School (Include School District)
Your answer
Birthdate
Your answer
Please fill out the information below for Child #3
Name
Your answer
Hebrew Name
Your answer
Grade and School (Include School District)
Your answer
Birthdate
Your answer
Please fill out the following information for Parent #1
Name
Your answer
Home Phone
Your answer
Work/Day Phone
Your answer
Cell Phone
Your answer
Can we send you text messages
Email
Your answer
Home Address
Please include city and zip code
Your answer
Please fill in the information below for Parent #2
Name
Your answer
Work/Day Phone
Your answer
Cell Phone
Your answer
Can we send you text messages?
Email
Your answer
Home Address
If different from Parent #1
Your answer
If we have to get in touch with you in the event of an emergency, please list your family's most reachable phone numbers
Your answer
Emergency Contact
Name & Relationship (other than parent)
Your answer
Phone
Your answer
Emergency Contact #2
Name & Relationship (other than parent)
Your answer
Phone
Your answer
You are almost done!
Here's a link to our student information and release form. Please print this form for EACH child and complete one copy per child in your family.
https://docs.google.com/document/d/1dcXdftbZmEhjXbbeosXzuk1lgQ5RiHpz-Dpl6SI-wLI/edit?usp=sharing
Please complete the captcha before submitting the form.
Submit
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