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Beit Sefer Chadash Renewal Form 2023-24 / 5784 ~ Returning Family Registration
Please verify reCaptcha before submitting the form.
Thank you for continuing your child(ren)'s Jewish education here at Am Tikvah!
Congregation Am Tikvah Beit Sefer Chadash "The New School"
Sunday & Hebrew School on the South Side of San Francisco
Enrollment Form Instructions:
As a returning family, you are already in our database. Please FIRST FIND YOUR RECORD by typing your name into the field above the SHALOM image. This form will automatically populate some of your information. This form assumes there are no changes to the students. If you are adding a new student, you must complete the Beit Sefer Chadash Enrollment form for that student.
Next, please fill out all applicable sections of this enrollment form, for up to three children.
Parent/guardian #1
First Name
Last Name
Email Address
Mobile Phone Number
Are there any changes to your contact info?
Please Select One
Yes
No
Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Are there any changes to the Second Parent/Guardian's contact info?
Please Select One
There is no second parent/guardian.
Yes, the second guardian's contact info has changed.
No, the second guardian's contact info has not changed.
Parent/Guardian #2
Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Email
Mobile Phone Number
Emergency Contact Info
Are there changes to your Emergency Contact info?
Please Select One
Yes, my emergency contact info has changed.
No, my emergency contact info is the same.
Emergency Contact Name
Relationship to Student
Mobile Number
How many children are returning students?
Please Select One
One
Two
Three
Student #1
Student Full Name
Grade Level
Please Select One
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
Are there any new medical conditions, learning differences, or new medications that could affect their religious school experience or any concerns or insights that would help us provide a positive learning environment?
Student #2
Student Full Name
Grade Level
Please Select One
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
Are there any new medical conditions, learning differences, or new medications that could affect their religious school experience or any concerns or insights that would help us provide a positive learning environment?
Student #3
Student Full Name
Grade Level
Please Select One
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
Are there any new medical conditions, learning differences, or new medications that could affect their religious school experience or any concerns or insights that would help us provide a positive learning environment?
Medical Emergency Contact Info
Has there been any changes to your family medical provider?
Please Select One
Yes, my medical provider information has changed.
No, my medical provider information has not changed.
Doctor's Name
Doctor's Phone Number
Insurance Company
Policy ID Number
Group Number
Tuition and Fees
Please choose your preferred payment option below. Tuition for the first student is $725 and $580 for each additional student (20% sibling discount). If you choose to pay in installments, you can set up your payments on the next page. You must pay in full by May 31, 2024.
*
Payment Options - 1 Student
Please Select One
Pay in Full - $725
Pay in Installments
Special Financial Arrangement
On the next screen, please choose to pay 9 monthly payments of $80.56, starting in Sept or 3 payments of $241.67 every 3 months in Sept, Dec, Mar.
*
Payment Options - 2 Students
Please Select One
Pay in Full - $1,305
Pay in Installments
Special Financial Arrangement
On the next screen, please choose to pay 9 monthly payments of $145, starting in Sept or 3 payments of $435 every 3 months in Sept, Dec, and Mar.
*
Payment Options - 3 Students
Please Select One
Pay in Full - $1,885
Pay in Installments
Special Financial Arrangement
On the next screen, please choose to pay 9 monthly payments of $209.44, starting Sept or 3 payments of $628.33 every 3 months in Sept, Dec, and Mar.
Please briefly describe your financial constraints (no tax returns are required).
Am Tikvah Sisterhood has generously approved partial scholarships for dues-paying member families!
Please choose the "Special Financial Arrangement" option to choose a financial arrangement that is different from paying the full cost per child. By choosing this option, you will not be charged through this form. Instead, you will be asked to enter a short written explanation of your financial situation (no tax forms necessary). Then, the office will contact you about a special financial arrangement. The information you write will not be seen by anyone other than office staff.
Thank you! We look forward to spending time together in the coming year, 5784!
Mon, October 2 2023 17 Tishrei 5784