Tzohar - Israeli After School Registration Form 2024/2025

We appreciate very much your investment in Jewish education.

Please use this form to register your child(ren) for our program.
The registration is not confirmed until we receive your payment. Thank you.

How many people are you registering? *

Child & Parent Information

FIRST CHILD FIRST NAME *

FIRST CHILD'S LAST NAME *

FIRST CHILD DATE OF BIRTH (MM/DD/YYYY) *

SCHOOL YOUR CHILD WILL BE ATTENDING IN 2025-26 YEAR *

WHAT GRADE YOUR CHILD WILL BE IN 2025-26 SCHOOL YEAR *

GENDER *

Male Female

WHAT IS YOUR CHILD'S LEVEL OF KNOWLEDGE OF HEBREW? *

FLUENT IN SPEECH, READING AND WRITING

FLUENT IN SPEECH ONLY / NO READING AND WRITING

OTHER

IF YOUR FIRST CHILD HAS ANY ALLERGY OR OTHER MEDICAL CONCERNS, PLEASE SPECIFY HERE.

I DECLARE THAT I MARKED THE CORRECT OPTION FOR THE FIRST CHILD *

PARENT'S NAME (PRIMARY CONTACT) *

PHONE NUMBER *

Contact email address *

Street Address *

City *

State *

Postal Code *

SECOND PARENT'S NAME

SECOND PARENT'S PHONE NUMBER

SECOND PARENT'S EMAIL

I UNDERSTAND THAT THE REGISTRATION IS FOR THE FULL YEAR AND I AM RESPONSIBLE TO PAY $10,000 OVER 10 MONTH *

Yes No

I ACKNOWLEDGE THAT THERE IS A NON-REFUNDABLE $1,000 REGISTRATION FEE PER CHILD IN ADDITION TO THE TUITION *

yes no

PLEASE COMMENT HERE IF YOU HAVE ANY ADDITIONAL QUESTIONS OR CONCERNS.

Registration

Tzohar Registration Fee

One Child - $ 1,000.00

Two Children - $ 2,000.00

- none -

Total for this participant

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

If you can, please consider adding a donation by clicking here. This will help us serve you better.

Tzohar After School Israeli a Program of Chabad Israeli Silicon Valley

1650 Channing Ave Palo Alto, 94303 CA

tzohar@chabadisraeli.org - 650.804.5019 - www.israeliafterschool.com

Chabad of My Town