The Hebrew Academy - A Yeshiva Day School serving Toddler through Eighth Grade

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Prospective Student Preliminary Application Form

How many legal Guardians are there in this household*
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How Many Students are you enrolling*
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Parent/Legal Guardian #1
Title*
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First Name*
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Last name*
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Hebrew Name*
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Have there been any conversions or adoptions in the family?*
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Who?*
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Address*
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City*
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State*
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Zip Code*
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Home Phone*
Please enter a Valid Phone Number

Please enter your 10 digit phone number.

Cell Phone
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Please enter your 10 digit phone number.

Work Phone
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Please enter your 10 digit phone number.

Email*
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Occupation*
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Marital Status*
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Synagogue Affiliations*
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Relationship to Student*
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Parent/Legal Guardian #2
Title*
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First Name*
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Last Name*
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Hebrew Name*
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Have there been any conversions or adoptions in the family?*
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Who?*
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Address*
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City*
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Sate*
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Zip Code*
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Home Phone*
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Please enter your 10 digit phone number.

Cell Phone
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Please enter your 10 digit phone number.

Work Phone
Invalid Input

Please enter your 10 digit phone number.

Email*
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Occupation*
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Marital Status*
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Synagogue Affiliations*
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Relationship to Student*
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Child #1
First Name*
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Last Name*
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Hebrew Name*
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Gender*
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Birthdate*
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Please enter date in the following format: mm/dd/yyyy (example 01/01/1990)

Grade Entering*
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Early Care
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After Care
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School District*
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*
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Child lives with*
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*
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Who has legal custody?*
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*
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Is non-custodial parent legally entitled to receive copies of school reports?*
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Is non-custodial parent legally entitled to pick up child from school?*
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Who has financial responsibility for this applicant?*
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*
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Present School*
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Contact Name*
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School Phone*
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Please enter a 10 digit phone number.

School Address*
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City*
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State*
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Zip Code*
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Date Attended*
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Grades Finished or in Progress*
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Approximate Grade of Judaic Studies*
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Approximate Grade of Secular Studies*
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Has your child been evaluated for concerns regarding
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If yes, please provide a copy of the assessment to the school office.

How would you describe your child's personality and/or behavioral characteristics?*
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What are your child's greatest strengths and weaknesses?*
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Describe your child's learning style (verbal, auditory, visual, kinesthetic) and the way he/she learns best?*
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How would you describe your child's academic performance/school experience to date?*
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Tell us about any special interests/talent in Music, Art, Religion, Athletics, Academics that you child has:*
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Please share with us some of the reasons you feel The Hebrew Academy would be a desirable environment for your child and family.*
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What are your educational expectations of The Hebrew Academy?*
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Does your child have any academic, physical, psychological or emotional issues that may require special accommodations by the school?*
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Child #2
First Name*
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Last Name*
Invalid Input

Hebrew Name*
Invalid Input

Gender*
Invalid Input

Birthdate*
Invalid Input

Please enter date in the following format: mm/dd/yyyy (example 01/01/1990)

Grade Entering*
Invalid Input

Early Care
Invalid Input

After Care
Invalid Input

School District*
Invalid Input

*
Invalid Input

Child lives with*
Invalid Input

*
Invalid Input

Who has legal custody?*
Invalid Input

*
Invalid Input

Is non-custodial parent legally entitled to receive copies of school reports?*
Invalid Input

Is non-custodial parent legally entitled to pick up child from school?*
Invalid Input

Who has financial responsibility for this applicant?*
Invalid Input

*
Invalid Input

Present School*
Invalid Input

Contact Name*
Invalid Input

School Phone*
Invalid Input

Please enter a 10 digit phone number.

School Address*
Invalid Input

City*
Invalid Input

State*
Invalid Input

Zip Code*
Invalid Input

Date Attended*
Invalid Input

Grades Finished or in Progress*
Invalid Input

Approximate Grade of Judaic Studies*
Invalid Input

Approximate Grade of Secular Studies*
Invalid Input

Has your child been evaluated for concerns regarding
Invalid Input

If yes, please provide a copy of the assessment to the school office.

How would you describe your child's personality and/or behavioral characteristics?*
Invalid Input

What are your child's greatest strengths and weaknesses?*
Invalid Input

Describe your child's learning style (verbal, auditory, visual, kinesthetic) and the way he/she learns best?*
Invalid Input

How would you describe your child's academic performance/school experience to date?*
Invalid Input

Tell us about any special interests/talent in Music, Art, Religion, Athletics, Academics that you child has:*
Invalid Input

Please share with us some of the reasons you feel The Hebrew Academy would be a desirable environment for your child and family.*
Invalid Input

What are your educational expectations of The Hebrew Academy?*
Invalid Input

Does your child have any academic, physical, psychological or emotional issues that may require special accommodations by the school?*
Invalid Input

Child #3
First Name*
Invalid Input

Last Name*
Invalid Input

Hebrew Name*
Invalid Input

Gender*
Invalid Input

Birthdate*
Invalid Input

Please enter date in the following format: mm/dd/yyyy (example 01/01/1990)

Grade Entering*
Invalid Input

Early Care
Invalid Input

After Care
Invalid Input

School District*
Invalid Input

*
Invalid Input

Child lives with*
Invalid Input

*
Invalid Input

Who has legal custody?*
Invalid Input

*
Invalid Input

Is non-custodial parent legally entitled to receive copies of school reports?*
Invalid Input

Is non-custodial parent legally entitled to pick up child from school?*
Invalid Input

Who has financial responsibility for this applicant?*
Invalid Input

*
Invalid Input

Present School*
Invalid Input

Contact Name*
Invalid Input

School Phone*
Invalid Input

Please enter a 10 digit phone number.

School Address*
Invalid Input

City*
Invalid Input

State*
Invalid Input

Zip Code*
Invalid Input

Date Attended*
Invalid Input

Grades Finished or in Progress*
Invalid Input

Approximate Grade of Judaic Studies*
Invalid Input

Approximate Grade of Secular Studies*
Invalid Input

Has your child been evaluated for concerns regarding
Invalid Input

If yes, please provide a copy of the assessment to the school office.

How would you describe your child's personality and/or behavioral characteristics?*
Invalid Input

What are your child's greatest strengths and weaknesses?*
Invalid Input

Describe your child's learning style (verbal, auditory, visual, kinesthetic) and the way he/she learns best?*
Invalid Input

How would you describe your child's academic performance/school experience to date?*
Invalid Input

Tell us about any special interests/talent in Music, Art, Religion, Athletics, Academics that you child has:*
Invalid Input

Please share with us some of the reasons you feel The Hebrew Academy would be a desirable environment for your child and family.*
Invalid Input

What are your educational expectations of The Hebrew Academy?*
Invalid Input

Does your child have any academic, physical, psychological or emotional issues that may require special accommodations by the school?*
Invalid Input

Child #4
First Name*
Invalid Input

Last Name*
Invalid Input

Hebrew Name*
Invalid Input

Gender*
Invalid Input

Birthdate*
Invalid Input

Please enter date in the following format: mm/dd/yyyy (example 01/01/1990)

Grade Entering*
Invalid Input

Early Care
Invalid Input

After Care
Invalid Input

School District*
Invalid Input

*
Invalid Input

Child lives with*
Invalid Input

*
Invalid Input

Who has legal custody?*
Invalid Input

*
Invalid Input

Is non-custodial parent legally entitled to receive copies of school reports?*
Invalid Input

Is non-custodial parent legally entitled to pick up child from school?*
Invalid Input

Who has financial responsibility for this applicant?*
Invalid Input

*
Invalid Input

Present School*
Invalid Input

Contact Name*
Invalid Input

School Phone*
Invalid Input

Please enter a 10 digit phone number.

School Address*
Invalid Input

City*
Invalid Input

State*
Invalid Input

Zip Code*
Invalid Input

Date Attended*
Invalid Input

Grades Finished or in Progress*
Invalid Input

Approximate Grade of Judaic Studies*
Invalid Input

Approximate Grade of Secular Studies*
Invalid Input

Has your child been evaluated for concerns regarding
Invalid Input

If yes, please provide a copy of the assessment to the school office.

How would you describe your child's personality and/or behavioral characteristics?*
Invalid Input

What are your child's greatest strengths and weaknesses?*
Invalid Input

Describe your child's learning style (verbal, auditory, visual, kinesthetic) and the way he/she learns best?*
Invalid Input

How would you describe your child's academic performance/school experience to date?*
Invalid Input

Tell us about any special interests/talent in Music, Art, Religion, Athletics, Academics that you child has:*
Invalid Input

Please share with us some of the reasons you feel The Hebrew Academy would be a desirable environment for your child and family.*
Invalid Input

What are your educational expectations of The Hebrew Academy?*
Invalid Input

Does your child have any academic, physical, psychological or emotional issues that may require special accommodations by the school?*
Invalid Input

 
How did you hear about The Hebrew Academy?*
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Family Name*
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How?*
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Payment Options*
It is required and may not be left blank

Please note: Your application is not complete until we have received your registration fees.

If you select Credit Card, you will have the opportunity to pay when you submit this form. If you select Check or Cash, please send your payment to The Hebrew Academy, 315 N. Main Street, New City, NY, 10956 Attn: Admissions.

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Please check the box in lieu of a Signature *
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Please check the box in lieu of a Signature *
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  • Office: 845-634-0951

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