Aleph Bay RegistrationDear Parents,We are currently accepting application forms for the 2022-2023 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 contact Chayale by Phone: 646 283 5126 or by Email:[email protected]. We look forward to a wonderful year of learning and growth.The best compliment we can get is telling your friends about us! Please spread the word to any other potential new Hebrew School families!Wishing you all a healthy and happy summer!If you are reregistering your child/ren please CLICK HERE Student InformationNumber of Children*Full Name*First NameLast NameHebrew Name**MaleFemaleE-mailBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearSchool*Grade Entering*Previous Jewish EducationChild 2Full Name 2*First NameLast NameHebrew Name**MaleFemaleE-mailBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearSchool*Grade Entering*Previous Jewish EducationChild 3Full Name 3*First NameLast NameHebrew Name**MaleFemaleE-mailBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearSchool*Grade Entering*Previous Jewish EducationParents InformationFather's Name*First NameLast NameHebrew NameFathers Jewish Status*Born JewishConvertedNot JewishIf Converted, Please provide Conversion Rabbi's informationCell Number*Area CodePhone NumberE-mail*Mother's Name*First NameLast NameHebrew NameCell Number*Area CodePhone NumberE-mail*Parents areMarriedDivorcedSingleMothers Jewish Status*Born JewishConvertedNot JewishIf Converted, Please provide Conversion Rabbi's informationMedical InformationAll details remain confidentialEmergency Contact*First NameLast NameEmergency Number*Area CodePhone NumberPediatrician*First NameLast NamePediatrician Number*Area CodePhone NumberAny allergies or medical condition we should be aware of?*YesNoIf YES please describe. Please specify which Child if more than one.Tuition ScheduleThese terms will apply should your child be accepted.Program & Tuition Agreement I hereby confirm my child’s enrollment in Aleph Bay Hebrew School.I represent that I am the custodial parent or legal guardian of the child that I am enrolling and that the informationI have provided is true and correct. I agree to Aleph Bay Hebrew School's terms and conditions as outlined in the Parent Handbook.I fully understand that this enrollment, as part of my commitment to a long-term Jewish education at Aleph Bay, is accepted only on the basis of the full year program, and agree to pay the full annual or Monthly fees accordingly. I understand that no refunds or adjustments will be made for absences including, but not limited to, illness or vacation.I fully understand that by choosing monthly payment, Aleph Bay will charge my card automatically every month (upon acceptance).Choose a Payment Option*Tuition fee covers all weekly programs & snacks & drinks.Pay by Year: $700 Tuition + $50 Supplies Fee + $50 Deposit feePay by Month (Sep.- June): $80 Tuition + $50 Supplies Fee + $50 Deposit feeKids in the Kitchen: $90Extra 7 sessions of Holiday programs. AB Students get $50 off regular priceAll Classes (save $50)Click here to learn more about Kids in the KitchenYour card will only be charged for the deposit fee. Monthly and Annual Payments will be Charged starting September 1st.Total$0.00Payment*Credit CardVisaMasterCardAmerican ExpressDiscoverCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2022202320242025202620272028202920302031Expiration YearBilling AddressStreet AddressStreet Address Line 2CityState / ProvincePostal / 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 SaharaYemenZambiaZimbabweOtherCountryCCV*3 or 4 Digit Security CodeImportant - PermissionsI (WE) HEREBY ENROLL OUR CHILD IN THE ALEPH BAY HEBREW SCHOOL OF SHEEPSHEAD BAY. IN THE EVENT OF A MEDICAL EMERGENCY AND NEITHER PARENT CAN BE REACHED, MEDICAL TREATMENT MAY BE PROVIDED AS NECESSARY. I HEREBY GIVE PERMISSION FOR MY (OUR) CHILD/REN TO PARTICIPATE IN ALL HEBREW SCHOOL ACTIVITES, JOIN IN CLASS AND SCHOOL TRIPS ON AND BEYOND SCHOOL PROPERTIES. MY (OUR) CHILD MAY BE PHOTOGRAPHED AND THE PICTURES MAY BE USED FOR PUBLICATION BY ALEPH BAY HEBREW SCHOOL OF SHEEPSHEAD BAY.SIGNATURE*My e-signature will be legally binding as a printed signature.Date*MonthDayYear Additional CommentsReferred BySubmitShould be Empty: This page uses TLS encryption to keep your data secure.