Registration Form - Chabad Jewish Center Reston

Chabad Hebrew School
Online Registration Form

NEW STUDENTS:
Please fill out ALL fields of this form.

RETURNING STUDENTS WITH NO NEW INFORMATION:
Go straight to payment. With payment you are agreeing to all the clauses contained in the form below.

If you have any questions or concerns that you would like to discuss with us, please contact us at 703.476.1829.

If you would prefer to fill out a hard copy and mail it into our office, simply print this form, and mail to Chabad of Reston-Herndon. 11654 Plaza America Dr. #775 Reston, VA 20190.

Please note that one registration form per child is needed.

Tuition: $995. ($950 before August 10). Included in the tuition are all the family events held at Hebrew School.

Our pre-school class will open subject to interest. 50% reduction in pre school tuition fees with sibling attending K +. Included in the tuition are all the family events held at Hebrew School.

No child will ever be turned away for lack of funds. Please reach out to us, we are committed to working with you.

If you are in position to contribute towards helping our tuition scholarship fund, we would be most appreciative. To donate CLICK HERE.

We look forward to a wonderful year of learning and growth.

Pay Online

This page uses a secure connection and your information will not be shared with anyone.

Annual tuition: $995. $950 early bird price (before August 10) $100 discount for registered referral. If you have chosen to add a contribution towards our scholarship fund, thank you! You can add it to tuition below, or go to our Donate Page.

Student Full Name

First Name Last Name

Students Hebrew Name

Father Full Name

First Name Last Name

Mother Full Name

First Name Last Name

Father E-mail

Mother E-mail

Address

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

Father Number

Mother Number

Area Code Phone Number

Emergency Number

Area Code Phone Number

Any allergies or Illness, If yes please explain

If there was a Jewish conversion of anybody in the family (parents or grandparents) please provide the contact for the sponsoring rabbi or Synagogue/Bet Din. If the childs birth mother or father are not jewish please let us know.

Grade child is entering

Birth Date

Month Day Year

Amount

$100$950$995

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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