Hebrew school registration form.
Parent
Last Name*
  Parent
First Name*
Child #1 Last Name*   Child #1 First Name*
Child #2 Last Name   Child #2 First Name
Child #3 Last Name   Child #3 Last Name
Payment and Address Information.

Registration/Tuition Fee $810 plus $40 deposit - Chabad Members $500 plus $60

  How will you be paying?
Name on Card      
Address*   City/State/Zip Code*
Phone*   Email*
Credit Card Num   Exp Date
Security Code      
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