LEV Academy New Student Enrollment Form
Please complete the enrollment form for any child who will be starting LEV Academy for the 2020-2021 school year. In order for your child to be assigned to his/her class, we MUST have a registration form submitted and payment received. In order for us to properly prepare for the upcoming academic year, we must have your registration forms by no later than May 22, 2020.
Email address *
Child's Full Name *
Your answer
Child's Hebrew Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Home Address *
Your answer
Public School Child Will Be Attending in 2020-2021 *
Your answer
Has Your Child Had Previous Hebrew School Experience? If So, Where? *
Your answer
Does your child have any medical or learning issues we need to be aware of? If so, please list and explain.
Your answer
Preferred Contact Phone Number *
Your answer
Parent/Guardian #1 Full Name *
Your answer
Parent/Guardian #2 Full Name (if not applicable, please enter N/A) *
Your answer
Parent/Guardian #1 Hebrew Name *
Your answer
Parent/Guardian #2 Hebrew Name (if not applicable, please enter N/A) *
Your answer
Parent/Guardian #1 Maiden Name (If applicable) *
Your answer
Parent/Guardian #1 Occupation *
Your answer
Parent/Guardian #1 Employer *
Your answer
Parent/Guardian #2 Occupation *
Your answer
Parent/Guardian #2 Employer *
Your answer
Is anyone in your family a Cohen or a Levi? *
Required
Are you interested in being the class parent for your child's class? *
How did you hear about LEV Academy? What factors lead you to decide to enroll your child in LEV Academy? *
Your answer
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