* Scholarships and Supplemental Scholarships are available and can be issued with proof of need. Please contact [email protected] directly regarding the Scholarship Determination Process. Thank you! Student Information Number of Children to be Enrolled 1234 1. Full Name* First Name Last Name 1. Hebrew Name First Name Last Name 1. Birth Date* Month Day Year 1. Time and city of birth* 1. School* 1. Previous Jewish Education 1. Grade entering* Kindergarten1st2nd3rd4th5th6th7th8th 1. Hebrew Speaking Proficiency:* NoneWellFairPoor 1. Hebrew Reading Proficiency:* NoneWellFairPoor Second Child: 2. Full Name First Name Last Name 2. Hebrew Name First Name Last Name 2. Birth Date Month Day Year 2. Time and city of birth 2. School 2. Previous Jewish Education 2. Grade entering Kindergarten 1st2nd3rd4th5th6th7th8th 2. Hebrew Speaking Proficiency: NoneWellFairPoor 2. Hebrew Reading Proficiency: NoneWellFairPoor Third Child: 3. Full Name First Name Last Name 3. Hebrew Name First Name Last Name 3. Birth Date Month Day Year 3. Time and city of birth 3. School 3. Previous Jewish Education 3. Grade entering Kindergarten 1st2nd3rd4th5th6th7th8th 3. Hebrew Speaking Proficiency: NoneWellFairPoor 3. Hebrew Reading Proficiency: NoneWellFairPoor Fourth Child: 4. Full Name First Name Last Name 4. Hebrew Name First Name Last Name 4. Birth Date Month Day Year 4. Time and city of birth 4. School 4. Previous Jewish Education 4. Grade entering Kindergarten 1st2nd3rd4th5th6th7th8th 4. Hebrew Speaking Proficiency: NoneWellFairPoor 4. Hebrew Reading Proficiency: NoneWellFairPoor Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Additional Notable Information Please let us know if there is any important information we need to be aware of (i.e. special needs, trouble in school, adoption/foster situation, divorce, etc.). Medical Information for All Students: Please list all allergies including drug allergies for each child:* Pediatrician Contact Information:* I acknowledge that I am working with my child's doctor to manage all necessary vaccinations to ensure the safety of my child while at Hebrew School.* Yes Parents Information Father's Name* First Name Last Name Father's Hebrew Name Father's Cell No.* Area Code Phone Number Father's Email* Mother's Name* First Name Last Name Mother's Hebrew Name Mother Jewish by:* BirthConversion If by Conversion, where was it completed? Mother's Cell No.* Area Code Phone Number Mother's Email* Emergency Contact Information Emergency Contact Name* First Name Last Name Phone Number* Area Code Phone Number Relationship to Child* Payment Tuition* One child/monthlyOne child/yearTwo Children/monthlyTwo Children/yearlyThree Children/monthlyThree Children/yearlyFour Children/monthlyFour Children/yearly I would like to sponsor a day of security for Hebrew School: Yes - $100No I would like to donate to the Hebrew School Scholarship Fund to help those who cannot afford: $18$50$75$100$180$500$1000$1800 Yes, I'd like to make this a monthly recurring payment. Total $0.00 Disclaimer: Tuition is billed yearly or monthly based on what you indicate above. The base price for yearly tuition is $900 (This includes the cost of onsite security). Each additional child is an additional 10% off the base price. Receive an additional $25 off when you make your yearly payment in full today! If you select to pay the first month of tuition now, you indicate that you are authorizing Chabad of Henderson to set up a monthly payment to be drafted the 1st of each month for 10 months for the appropriate amount. Refunds for children withdrawing from school before the end of the school year will be granted provided that the school office is given 30 days written notice. Tuition refunds will not be granted to children withdrawing from school after April 1st . Tuition billed monthly will not be refunded after it has been charged. I Understand and Agree: to the above.* Yes E-mail Receipt to: Payment* Credit Card Other Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearCash or CheckBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country I would like to receive news and updates by email Submit Print Form Should be Empty: This page uses TLS encryption to keep your data secure.