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Child's Information

Last Name

First Name

Hebrew Name

Gender

Date of Birth:      Place of Birth:

Address

City

Province

Postal Code

Home Phone

Previous School

 

 

II. Family Orientation:

Mom's Name: 

Home Address (if Different from the child): 

Occupation:  Bus phone: 

Business Address: 

Cell Phone  Email: 

 

Dad's Name: 

Home Address (if Different from the child): 

Occupation:  Bus phone: 

Business Address: 

Cell Phone  Email: 

  

Marital Status of Parents: Married    Separated     Divorced    Other 

Language Spoken at Home: 

 

 

Enrollment Options / Tuition & Fees

 

CHILD IS APPLYING FOR ADMISSION TO: 
AGE:                 
DAYS PER WEEK: 
Hrs Per Day:      
For the Academic year of      Beginning in the month of 


Total Tuition Fee

* Application fee ($100.00) will be processed immediately. Registration fee (one months tuition) will be processed after admission has been confirmed.
* Please note: A %2 fee will be applied for credit card payments.

Payment Information

Registration Fee

Card Type

Card Number

Expiration Date

Security Code

Name on Card

Billing address

Billing Postal code