Register

Please complete the application form below to apply for the Online Hebrew School. The application will be reviewed by the Nigiri Online Hebrew School and you should expect to hear back shortly after their review.

For any questions, please email Leah at [email protected].
Child's Name*

First Name Last Name
Gender*

Male Female
Birth Date*

Month Day Year
Approx. time of birth
Current Grade
Applying for*

Online Hebrew School Online Bar/Bat Mitzvah Lessons
Parent's Information
Mother's Name*

First Name Last Name
Father's Name*

First Name Last Name

Address*

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

Home Phone*

Area Code Phone Number
Father's Cell*

Area Code Phone Number
Mother's Cell*

Area Code Phone Number
Father's Email*
Mother's Email*
Father Jewish By?*

Birth Conversion Other
Mother Jewish By?*

Birth Conversion Other
Family Information
Paternal Grandfather*

Jewish Converted Other
Paternal Grandmother*

Jewish Converted Other
Maternal Grandfather*

Jewish Converted Other
Maternal Grandmother*

Jewish Converted Other
Were there any adoptions in the family?*

Yes No
Additional Information
Briefly describe your Jewish life at home.
Are you currently affiliated with a Jewish community?* Shul, Temple, Synagogue, JCC, other Hebrew School, Chabad, etc.
Does your child currently receive any other Jewish education? Please elaborate.
How many years of formal Jewish studies has your child received? Where?*
Does he/she know the Hebrew alphabet?*

Beginner Intermediate Advanced
Can your child read simple Hebrew words?*

Beginner Intermediate Advanced
Please indicate anything you feel we need to know about your child.
What day of the week works out best for your child?*
Which day of the week do you prefer?*

Sunday Thursday
What time works out best for your child?*
Payment Information
Once you have been approved you will be billed monthly based on the classes you've selected.

Please note: You will be charged a registration fee of $99 and the Hebrew School book fee of $124.

Submit your registration form before July 1 to save on the registration fee.

New Students: These charges will be processed only after enrollment is complete. Although you may see a hold, it will NOT be charged till we get in touch with you and a class is arranged.

As you will see in the handbook, the book fee covers all books and shipments you will be receiving from us throughout the year.

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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