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
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