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Hebrew School | Tribeca Synagogue
Registration for the 2022-2023 School Year
Application:
*
Are you a Member?
Yes
No
Parent 1
*
Parent #1 First Name
*
Parent #1 Last Name
*
Relationship to Student(s)
Email
*
Cell Phone
Work Phone
Parent 2
Parent #2 First Name
Parent #2 Last Name
Relationship to Student(s)
Email
Parent # 2 Cell Phone
Parent #2 Work Phone
Address
*
Home Address for Student(s)
*
City, State, Zip
*
Home Phone
*
May we take & use your child(ren)'s photo?
Please Select One
Yes
No
Student 1
*
Student #1 First Name
*
Last Name
Hebrew Name
*
Date of Birth
*
Public School Grade 0-12
Child's email for online homework
Allergies to FOODs
Allergies to MEDICINES
Child's Doctor
Doctor's Phone
Learning or Behavior Issues
My child has an IEP (and I will share it with the Ed Dir.)
Yes
No
Student 2
Student #2 First Name
Student #2 Last Name
Student #2 Hebrew Name
Date of Birth
Public School Grade (0-12)
Child's email for Online Homework
Allergies to FOODs
Allergies to Medicines
Child's Doctor
Doctor's Phone
Learning or Behavior Issues
This child as an IEP (and I will share it with the Ed Dir.)
Yes
No
Student 3
Student #3 First Name
Student #3 Last name
Hebrew Name
Date of Birth
Public School Grade (0-12)
Child's email (for Online Homework)
Allergies to FOODs
Allergies to Medicines
Child's Doctor
Dr's Phone
Learning or Behavior Issues
This child has an IEP (which I will share with the Ed Dir)
Yes
No
Student 4
Student #4 First name
Student #4 Last name
Hebrew Name
Date of Birth
Public School grade (0-12)
Child's email for Online Homework
Allergies to FOODs
Allergies to Medicines
Child's Doctor
Dr's Phone
Learning or Behavior Issues
This child has an IEP (which I will share with the Ed Dir)
Yes
No
Wed, July 2 2025 6 Tammuz 5785