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

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Returning Students

How many legal Guardians are there in this household*
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How Many Students are you enrolling*
Please select how many students you are enrolling

 
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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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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Address*
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City*
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State*
Invalid Input

Zip Code*
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Home Phone*
Invalid Input

Please enter your 10 digit phone number.

Cell Phone
Invalid Input

Please enter your 10 digit phone number.

Work Phone
Invalid Input

Please enter your 10 digit phone number.

Email*
Invalid Input

Occupation*
Invalid Input

Marital Status*
Invalid Input

Synagogue Affiliations*
Invalid Input

Relationship to Student*
Invalid Input

 
Child #1
First Name*
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Last Name*
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Hebrew Name*
Invalid Input

Gender*
Please select your Child's Gender

Birthdate*
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Grade Entering*
Please select the grade your child is entering

Early Care
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After Care
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School District*
Please select the district your Child resides in

*
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Child lives with*
Please select who your child live with

*
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Who has legal custody?*
Please select who has legal custody

*
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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?*
Please select who has financial responsibility

*
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Child #2
First Name*
Invalid Input

Last Name*
Invalid Input

Hebrew Name*
Invalid Input

Gender*
Please select your Child's gender

Birthdate*
Invalid Input

Grade Entering*
Please select the grade your child is entering

Early Care
Invalid Input

After Care
Invalid Input

School District*
Invalid Input

*
Invalid Input

Child lives with*
Please select who your child live with

*
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 receive copies of school reports?

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

New Student?

Invalid Input

Child #3
First Name*
Invalid Input

Last Name*
Invalid Input

Hebrew Name*
Invalid Input

Gender*
Please select your Child's Gender

Birthdate*
Invalid Input

Grade Entering*
Please select the grade your child is entering

Early Care
Invalid Input

After Care
Invalid Input

School District*
Invalid Input

*
Invalid Input

Child lives with*
Please select who your child live with

*
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 receive copies of school reports?

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

New Student?
Invalid Input

Child #4
First Name*
Invalid Input

Last Name*
Invalid Input

Hebrew Name*
Invalid Input

Gender*
Please select your Child's Gender

Birthdate*
Invalid Input

Grade Entering*
Please select the grade your child is entering

Early Care
Invalid Input

After Care
Invalid Input

School District*
Invalid Input

*
Invalid Input

Child lives with*
Please select who your child live with

*
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

New Student?
Invalid Input

 
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.

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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