Student Registration 1999-2000 - May 1999

Congregation Albert Religious/Hebrew School

Please print this frame, then fill it out and mail it to Congregation Albert with your deposit. Thank you. Please note: this form may be used for up to three students. If you wish to register more than three students, you can either use a separate piece of paper or print the form more than once.

Parent's Name(s): _______________________________________________

Address: ______________________________________________________

Zip Code: ____________________

Phone Number: __________________

Student's Mailing Address: __________________________________________

Father's Daytime Phone: _______________________

Mother's Daytime Phone: _______________________

Student 1:

Name: _______________________________

Date of Birth: __________________________

RELIGIOUS SCHOOL

Grade Entering in September 1999 __________

Hours:

Grades K-6: Sunday 9:30 AM - 12:00 PM

Grades 7-10: Wednesday 6:30 PM - 8:00 PM
(except as noted on school calendar)

HEBREW SCHOOL

Grade Entering in September 1999 __________

Hours (please circle your choice):

EARLY:
Monday & Wednesday 4:00 PM - 5:30 PM

LATE:
Monday & Wednesday 5:45 PM - 7:15 PM

Student 2:

Name: _______________________________

Date of Birth: __________________________

RELIGIOUS SCHOOL

Grade Entering in September 1999 __________

Hours:

Grades K-6: Sunday 9:30 AM - 12:00 PM

Grades 7-10: Wednesday 6:30 PM - 8:00 PM
(except as noted on school calendar)

HEBREW SCHOOL

Grade Entering in September 1999 __________

Hours (please circle your choice):

EARLY:
Monday & Wednesday 4:00 PM - 5:30 PM

LATE:
Monday & Wednesday 5:45 PM - 7:15 PM

Student 3:

Name: _______________________________

Date of Birth: __________________________

RELIGIOUS SCHOOL

Grade Entering in September 1999 __________

Hours:

Grades K-6: Sunday 9:30 AM - 12:00 PM

Grades 7-10: Wednesday 6:30 PM - 8:00 PM
(except as noted on school calendar)

HEBREW SCHOOL

Grade Entering in September 1999 __________

Hours (please circle your choice):

EARLY:
Monday & Wednesday 4:00 PM - 5:30 PM

LATE:
Monday & Wednesday 5:45 PM - 7:15 PM

FEE SCHEDULE

Religious School fees are as follows:

Tuition for 1998-1999 classes must be paid in full before a student will be permitted to register for 1999-2000 classes. No applications will be accepted without either a deposit check or completed scholarship application attached. Scholarship application forms are available in the Religious School or Temple office.

** PLEASE SUBMIT REGISTRATION FORM BY JUNE 15, 1999 **

EMERGENCY MEDICAL PROVISIONS

Who should be notified in case of an emergency if parents cannot be reached?

Name: _________________________________

Relationship: _____________________________

Phone: __________________________________

I hereby give my permission for emergency medical transportation: Yes_____ No_____

I hereby give my permission for emergency medical treatment: Yes_____ No_____

I hereby give permission for __________________________________(Name(s) of Child(ren)) to attend any activity of the Religious School and/or Hebrew School, such as field trips, during the school year, if under adult supervision Yes_____ No_____

Date: ____________________

Signature of Parent or Guardian: __________________________________

THIS FORM MUST BE COMPLETED IN FULL BEFORE A STUDENT CAN BE ADMITTED TO ANY RELIGIOUS OR HEBREW CLASSES.

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