Chabad Hebrew School West Houston Registration
2019/2020 - 5779/5780

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Please fill out this form as an initial registration for the Chabad Hebrew School.

Confirmation of acceptance will be acknowledged only after this registration form is reviewed and an acceptance letter is received.

Student Information

Male Female

Does you child read basic Hebrew?            
  None Somewhat Well

Does your child speak/understand Hebrew? None Somewhat Well

Does your child have previous Jewish Education Yes No
If yes, please describe:

What school does your child attend? Grade entering:
Synagogue affiliated with:
Is the natural mother of the child Jewish? Yes No
Were there any conversions or adoptions in your family? Yes No
If yes, please describe:

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):


Parent Information


Emergency Contact Information
Please list two contacts to be used in case of emergencies (other than your home and business numbers).

Please send a copy of your insurance card for our files.

Up to date with vaccinations? Yes No Date of last tetanus shot:

Accept Do Not Accept
Initial here:



The following is a tuition agreement for the Chabad Hebrew School. The agreement explains the tuition fees, payments plans and refund policies. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes.

The tuition for the Chabad Hebrew School is $700.00 per year per child (this includes registration & book fee).

Discounts: There is a 10% discount off of the regular tuition for each additional child of the same family. There is a 10% additional discount off your total tuition for each child of another family you successfully introduce to the Chabad Hebrew School.

You may choose from the following payment methods:

PLAN A: You may pay the entire amount for the Hebrew school only in full with a check, cash or credit card $700. (Fill out your credit card information at the bottom of the page)         

PLAN B: You many pay the annual tuition for the Hebrew school only on a monthly basis by submitting 10 checks of $70.00 each, dated August through May. All checks must be submitted before the first day of Hebrew School.   

PLAN C: You may use your credit card to pay the tuition for the Hebrew School only on a monthly basis. Your credit card will be billed $70.00 monthly August through May. To do so please include your credit card number and expiration date at the bottom of this page.                                                                      

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Your FULL name here:


Payment Options: (You must select Plan A, B or C above)
Charge the Credit Card below for payment to Chabad West Hebrew School
VISA MasterCard Discover American Express Check (in mail)

Check or Card No.

Check Date or Card Expiration: mm/yyyy / Security Code

I heard about the Chabad Hebrew School from: