The Hebrew Academy

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Returning Parents
  1. How many legal Guardians are there in this household*
    Invalid Input
  2. How Many Students are you enrolling*
    Please select how many students you are enrolling.
  3.  
  1. Parent/Legal Guardian #1
  2. Title*
    Invalid Input
  3. Last Name*
    Please enter your Last Name
  4. First Name*
    Please enter your First Name
  5. Hebrew Name*
    Please enter your Hebrew Name
  6. Address*
    Please enter your Address
  7. City*
    Please enter the City that you reside in.
  8. State*
    Please enter the State that you reside in
  9. Zip Code*
    Please enter your Zip Code
  10. Home Phone*
    Please enter a Valid Phone Number
  11. Cell Phone
    Please enter a valid Phone Number
  12. Work Phone
    Please enter a valid Phone Number
  13. Email*
    Please enter a valid email address
  14. Occupation*
    Please enter your occupation
  15. Marital Status*
    Invalid Input
  16. Synagogue Affiliations*
    Please enter the Synagogue that you are affiliated with
  17. Relationship to Student*
    Invalid Input
  18. Parent/Legal Guardian #2
  19. Title*
    Invalid Input
  20. Last Name*
    Please enter your Last Name
  21. First Name*
    Please enter your first name
  22. Hebrew Name*
    Please enter your Hebrew Name
  23. Address*
    Please enter your Address
  24. City*
    Please enter the City that you reside in.
  25. Sate*
    Please enter the State that you reside in.
  26. Zip Code*
    Please enter a valid zip code
  27. Home Phone*
    Please enter a valid phone number
  28. Cell Phone
    Please enter a valid phone number
  29. Work Phone
    Please enter a valid phone number
  30. Email*
    Please enter a valid email address
  31. Occupation*
    Please enter your occupation
  32. Marital Status*
    Invalid Input
  33. Synagogue Affiliations*
    Please enter the Synagogue that you are affiliated with
  34. Relationship to Student*
    Invalid Input
  35.  
  1. Child #1
  2. First Name*
    Invalid Input
  3. Last Name*
    Invalid Input
  4. Hebrew Name*
    Invalid Input
  5. Gender*
    Invalid Input
  6. Birthdate*
    Invalid Input
  7. Grade Entering*
    Invalid Input
  8. School District*
    Invalid Input
  9. *
    Invalid Input
  10. Child lives with*
    Invalid Input
  11. *
    Invalid Input
  12. Who has legal custody?*
    Invalid Input
  13. *
    Invalid Input
  14. Is non-custodial parent legally entitled to receive copies of school reports?*
    Invalid Input
  15. Is non-custodial parent legally entitled to pick up child from school?*
    Invalid Input
  16. Who has financial responsibility for this applicant?*
    Invalid Input
  17. *
    Invalid Input
  18. Child #2
  19. First Name*
    Invalid Input
  20. Last Name*
    Invalid Input
  21. Hebrew Name*
    Invalid Input
  22. Gender*
    Invalid Input
  23. Birthdate*
    Invalid Input
  24. Grade Entering*
    Invalid Input
  25. School District*
    Invalid Input
  26. *
    Invalid Input
  27. Child lives with*
    Invalid Input
  28. *
    Invalid Input
  29. Who has legal custody?*
    Invalid Input
  30. *
    Invalid Input
  31. Is non-custodial parent legally entitled to receive copies of school reports?*
    Invalid Input
  32. Is non-custodial parent legally entitled to pick up child from school?*
    Invalid Input
  33. Who has financial responsibility for this applicant?*
    Invalid Input
  34. *
    Invalid Input
  35. New Student

    Invalid Input
  36. Child #3
  37. First Name*
    Invalid Input
  38. Last Name*
    Invalid Input
  39. Hebrew Name*
    Invalid Input
  40. Gender*
    Invalid Input
  41. Birthdate*
    Invalid Input
  42. Grade Entering*
    Invalid Input
  43. School District*
    Invalid Input
  44. *
    Invalid Input
  45. Child lives with*
    Invalid Input
  46. *
    Invalid Input
  47. Who has legal custody?*
    Invalid Input
  48. *
    Invalid Input
  49. Is non-custodial parent legally entitled to receive copies of school reports?*
    Invalid Input
  50. Is non-custodial parent legally entitled to pick up child from school?*
    Invalid Input
  51. Who has financial responsibility for this applicant?*
    Invalid Input
  52. *
    Invalid Input
  53. New Student
    Invalid Input
  54. Child #4
  55. First Name*
    Invalid Input
  56. Last Name*
    Invalid Input
  57. Hebrew Name*
    Invalid Input
  58. Gender*
    Invalid Input
  59. Birthdate*
    Invalid Input
  60. Grade Entering*
    Invalid Input
  61. School District*
    Invalid Input
  62. *
    Invalid Input
  63. Child lives with*
    Invalid Input
  64. *
    Invalid Input
  65. Who has legal custody?*
    Invalid Input
  66. *
    Invalid Input
  67. Is non-custodial parent legally entitled to receive copies of school reports?*
    Invalid Input
  68. Is non-custodial parent legally entitled to pick up child from school?*
    Invalid Input
  69. Who has financial responsibility for this applicant?*
    Invalid Input
  70. *
    Invalid Input
  71. New Student
    Invalid Input
  72.  
  1. 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, when you submit this form,you will be redirected to PayPal. If you select Check or Cash, please send your payment to The Hebrew Academy, 315 N. Main Street, New City, NY, 10956 Attn: Admissions.

  2. Please check the box in lieu of a Signature *
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  3. Please check the box in lieu of a Signature *
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  4. Submit
      

© 2013 The Hebrew Academy
315 N. Main Street    New City, NY 10956
Phone: 845-634-0951 Fax: 845-634-7704