Early Registration Form

CONDITIONS OF ENROLLMENT: Please complete the Early Registration for your child(ren) Please Note: The Early Registration fee must be paid for each child.

General:

By parents enrolling their child(ren) in Esformes Hebrew Academy (EHA), students and parents agree to abide by all of the Conditions of Enrollment and standards of conduct as set forth by EHA as well as the rules and regulations established by EHA for the health, safety, and welfare of the students. Your child will not be accepted, verbally or in writing, unless all forms and full payment have been sent to the office.

Tuition and Installments:

The $200 Early Registration fee per child ($350 Registration after March 16th). If your first installment and is non-refundable unless you were not accepted or if you meet our refund policy. (See Below)

Full tuition installment payments will begin in June 1st, 2020 ending in FULL on March 1, 2021. I agree that in accordance to the monthly installments full tuition will be paid in full by March 1, 2021. I authorize EHA to charge the payment method in my account for the monthly installments. I agree and understand that if my first installment payment is not made according to the agreement my child(ren)’s spot could be released.

Financial Fees:

All credit cards are subject to a 3% convenience fee. All returned checks are subject to a $35 returned item fee.

Father's Name*

First Name Last Name

Mother's Name*

First Name Last Name

Home Phone Number*

Area Code Phone Number

Father's Cell Number

Area Code Phone Number

Father's E-mail

Mother's Cell Number

Area Code Phone Number

Mother's Email

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Child 1 Name*

First Name Last Name

Child 1 Gender*

Male Female

Child 1 Hebrew Name*

Child 1 Hebrew Birth Date*

If you do not know your child's Hebrew date of birth, please click here .

Child 1 English Birth Date*

Month Day Year

Child 1 Incoming Preschool Level* Please select Grade Level AND Full or Part Time

Torah Tots/Pre-K2 Pre-K (3yr olds & 4yr olds) Part-Time Full-Time No Preschooler

Child 1 Incoming Grade Level*

Child 2 Name

First Name Last Name

Child 2 Gender

Male Female

Child 2 Hebrew Name

Child 2 Hebrew Birth Date

If you do not know your child's Hebrew date of birth, please click here .

Child 2 English Birth Date

Month Day Year

Child 2 Incoming Preschool Level Please select Grade Level AND Full or Part Time

Torah Tots/Pre-K2 Pre-K (3yr olds & 4yr olds) Part-Time Full-time

Child 2 Incoming Grade Level

Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Child 3 Name

First Name Last Name

Child 3 Hebrew Name

Child 3 Gender

Male Female

Child 3 Hebrew Birth Date

If you do not know your child's Hebrew date of birth, please click here.

Child 3 English Birth Date

Month Day Year

Child 3 Incoming Preschool Level Please select Grade Level AND Full or Part Time

Torah Tots/Pre-K2 Pre-K (3yr olds & 4yr olds) Part-Time Full-Time

Child 3 Incoming Grade Level

Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Child 4 Name

First Name Last Name

Child 4 Hebrew Name

Child 4 Gender

Male Female

Child 4 Hebrew Birth Date

If you do not know your child's Hebrew date of birth, please click here.

Child 4 English Birth Date

Month Day Year

Child 4 Incoming Preschool Level Please select Grade Level AND Full or Part Time

Torah Tots/Pre-K2 Pre-K (3yr olds & 4yr olds) Part-Time Full-Time

Child 4 Incoming Grade Level

Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Child 5 Name

First Name Last Name

Child 5 Hebrew Name

Child 5 Gender

Male Female

Child 5 Hebrew Birth Date

If you do not know your child's Hebrew date of birth, please click here.

Child 5 English Birth Date

Month Day Year

Child 5 Incoming Preschool Level Please select Grade Level AND Full or Part Time

Torah Tots/Pre-K2 Pre-K (3yr olds & 4yr olds) Part-Time Full Time

Child 5 Incoming Grade Level

Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Child 6 Name

First Name Last Name

Child 6 Hebrew Name

Child 6 Gender

Male Female

Child 6 Hebrew Birth Date

If you do not know your child's Hebrew date of birth, please click here.

Child 6 English Birth Date

Month Day Year

Child 6 Incoming Preschool Level Please select Grade Level AND Full or Part Time

Torah Tots/Pre-K2 Pre-K (3yr olds & 4yr olds) Part-Time Full time

Child 6 Incoming Grade Level

Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

2020-2021 SCHOOL YEAR IMPORTANT NEW PAYMENT METHOD

By submitting this registration I agree to the Terms and Conditions with Esformes Hebrew Academy and acknowledge that I read and understand these conditions as well as the Esformes Handbook. To access please go to our website.

Parent/Guardian Electronic Signature*

I agree to EHA Policy, Procedures and Terms and Conditions*

Select

Payment*

Credit Card Check or Cash

Postal / Zip Code

Country

Parent/Guardian Electronic Signature*

Time Stamp

Month Day Year

at Hour Minutes

I would like to receive news and updates by email

Early Registration is open from February 17th-March 16th

Parent Information

Student Information

Payment For Early Registration