Hebrew School | Tribeca Synagogue

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Registration for the 2022-2023 School Year

Application:

* Are you a Member?

YesNo

Parent 1

* Parent #1 First Name

* Parent #1 Last Name

* Relationship to Student(s)

* Cell Phone

Work Phone

Parent 2

Parent #2 First Name

Parent #2 Last Name

Relationship to Student(s)

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?

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.)

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.)

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)

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)

Fri, February 3 2023 12 Shevat 5783