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Student Profile
First Name
Last Name
Hebrew Name
DOB
School
Grade Entering
Hebrew Reading Proficiency
Previous Jewish Education
Where?

 
Parent Information
Father's Name
Phone
Mother's Name
Phone
Address
City
State
Zip
Email Address
 
Emergency Information
Emergency Contact 1
Phone
Emergency Contact 2
Phone
Doctor
Address
Phone
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.
 
Payment Information

RSF Hebrew School of the Arts!
$120/month -Includes all Textbooks, Supplies, and Trips!

Total Amount:

Please consider an added donation to our scholarship fund
Credit Card Number
CVV
Expiration Date

 

 As always, no child will be turned away due to lack of funds! SCHOLARSHIPS AVAILABLE  

Authorization
Transport / Emergency Care as listed above Authorization
 
Media Authorization