Printed fromChabadMercerIsland.org

Island Hebrew School

Inspiring Jewish Pride and Identity in Jewish Children - the future of Judaism.

ב"ה

Registration

Register your child for the new year.
We are currently accepting application forms for the 2024-2025 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please feel free to contact us.

We look forward to providing your children with an outstanding Hebrew and Jewish education!

Returning Students Register Here
HOW MANY CHILDREN ARE YOU REGISTERING TODAY?*

12
Child 1*

First Name Hebrew Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
School*
Grade Entering*
Child 2*

First Name Hebrew Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
School*
Grade Entering*
WERE THERE ANY CONVERSIONS OR ADOPTIONS IN THE FAMILY?**

YesNo
2. Parent information
Parent 1 info - Name:*
Phone Number*

Area Code Phone Number
E-mail*

Address*

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

Parent 2 info - Name:*
Phone Number*

Area Code Phone Number
E-mail* Primary email

Address (if Different)

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

Marital Status*

MarriedDivorcedSeparated
Mother Born Jewish?*

YesConvertedNot Jewish
Converted By Whom?
3. Emergency Information
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Pediatrician*

First Name Last Name
Phone Number*

Area Code Phone Number
Insurance*
Policy #*
5. RATES
Annual Tuition: $1,149

Please note that no child will be turned away due to lack of funds. Please contact the office here to discuss any financial considerations.
*

I understand the rates
5. ENROLLMENT
After you have successfully submitted your application it will be subject to review. A team member will reach out to schedule a follow up call to discuss your application and confirm it's approval. Once approved an invoice will be sent to complete your child's enrollment.

We look forward to providing your children with an outstanding Hebrew and Jewish education!
Registration Fee
$50/Child*
Total

$50.00

Payment*

Credit Card Paypal

Postal / Zip Code

Country

Should be Empty:

This page uses TLS encryption to keep your data secure.

Educate Your Child... Educate a Generation