Sha'are Shalom Religious School Registration 2019-2020
Student One Last Name *
Your answer
Student One First Name *
Your answer
Student One Hebrew Name
Your answer
Date of Birth (mm/dd/yyyy) *
Your answer
Is your child Jewish by birth? (Note: according to Jewish law, a child is Jewish by birth if the mother is Jewish) *
If "No" to the previous question, has your child been formally converted to Judaism?
Grade in secular school (as of 8/19) *
Name of School Child Attends (as of 08/19). If your child is being homeschooled, please write "Homeschool". *
Your answer
Does your child have an IEP at school? If "Yes", we ask that you please share a copy with us. *
I would like to register my child for Kadima (Grades 6-8; the fee will appear on your invoice. You will still need to fill out an information form later on)
I would like to register my child for USY (Grades 9-10; the fee will appear on your invoice. You will still need to fill out an information form later on)
Please take a moment to tell us what are your family's goals for your child's Jewish education and how we can help you achieve them. *
Your answer
Student Two Last Name
Your answer
Student Two First Name
Your answer
Student Two Hebrew Name
Your answer
Date of Birth (mm/dd/yyyy)
Your answer
Is your child Jewish by birth? (Note: according to Jewish law, a child is Jewish by birth if the mother is Jewish).
If "No" to the previous question, has your child been formally converted to Judaism?
Grade in secular school (as of 8/19)
Name of school child attends (as of 08/19). If your child is being homeschooled, please write "Homeschool".
Your answer
Does your child have an IEP at school? If "Yes", we ask that you please share a copy with us.
I would like to register my child for Kadima (Grades 6-8; the fee will appear on your invoice. You will still need to fill out an information form later on)
I would like to register my child for USY (Grades 9-10; the fee will appear on your invoice. You will still need to fill out an information form later on)
Please take a moment to tell us what are your family's goals for your child's Jewish education and how we can help you achieve them.
Your answer
Student Three Last Name
Your answer
Student Three First Name
Your answer
Student Three Hebrew Name
Your answer
Date of Birth (mm/dd/yyyy)
Your answer
Is your child Jewish by birth? (Note: According to Jewish law, a child is born Jewish if the mother is Jewish)
If "No" to the previous question, has your child been formally converted to Judaism?
Grade in secular school (as of 08/19)
Name of school child attends (as of 08/19). If your child is being homeschooled, please write "Homeschool".
Your answer
Does your child have an IEP at school? If "Yes", we ask that you share a copy with us.
I would like to register my child for Kadima (Grades 6-8; the fee will appear on your invoice. You will still need to fill out an information form later on)
I would like to register my child for USY (Grades 9-10; the fee will appear on your invoice. You will still need to fill out an information form later on)
Please take a moment to tell us what are your family's goals for your child's Jewish education and how we can help you achieve them.
Your answer
Student Street Address *
Your answer
City
Your answer
State
Zip Code
Your answer
Parent One Last Name *
Your answer
Parent One First Name *
Your answer
Religion *
Your answer
Occupation
Your answer
Does Parent One live at the same address as student? If "Yes", skip ahead to Preferred Phone Contact. *
Street Address
Your answer
City
Your answer
State
Your answer
Preferred Phone Contact for Parent One (e.g. 703-777-7777) *
Your answer
Is this a mobile phone or land line? *
E-mail Address *
Your answer
Send Religious School E-mail to this Address? *
Would Parent One like to serve on the School Committee? *
Would Parent One like to serve as a Room Parent? *
If "Yes" to serving as a Room Parent, for which child's class (if more than one child)?
Your answer
Is Parent One interested in serving as a substitute teacher? *
If "Yes" to serving as a substitute teacher, which day (s) are you available?
If "Yes" to serving as a substitute teacher, are you comfortable subbing in a Hebrew class?
Do you have a special talent or skill you would be willing to share with our students? Please specify.
Your answer
Parent Two Last Name
Your answer
Parent Two First Name
Your answer
Religion
Your answer
Occupation
Your answer
Does Parent Two live at the same address as student? If "Yes", skip ahead to Preferred Phone Contact.
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Preferred Phone Contact for Parent Two (e.g. 703-777-7777)
Your answer
Is this a mobile phone or land line?
E-mail Address
Your answer
Send Religious School e-mail to this address?
Would Parent Two like to serve as a Room Parent?
If "Yes" to serving as a Room Parent, for which child's class (if more than one child)?
Your answer
Is Parent Two interested in serving as a substitute teacher?
If "Yes" to serving as a substitute teacher, which day(s) are you available?
If "Yes" to serving as a substitute teacher, are you comfortable subbing in a Hebrew class?
Do you have a special talent or skill you would like to share with our students? Please specify.
Your answer
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