We are currently accepting application forms for the 2018-2019 school year.

Please fill out ALL fields of this form.

If you have any questions or concerns you'd like to discuss with us feel free to call our director Mindy Wolff at 305-307-9108 or email Mindy@ChabadHomeBay.com.

* If you prefer you can download a   'Printer Friendly' Form   and mail it to 8460 SW 198th St Miami, FL. 33189. For previous students please download the quick pass 'Printer Friendly' Form

Student 1 Profile
First Name 
Last Name 
Hebrew Name 
Age 
DOB 
 

In Judaism the day begins at nightfall, so to determine the exact date of the Jewish birthday we need to know the time of day.
School 
Grade Entering 
Hebrew Reading Proficiency 
 None  Somewhat  Well
Previous Jewish Education 
 Yes  No
Where? 
Does your child have any learning disabilities? Please specify 

This information will help us better cater to the needs of your child.
 
Student 2 Profile
First Name 
Last Name 
Hebrew Name 
Age 
DOB 
Time of Birth 

In Judaism the day begins at nightfall, so to determine the exact date of the Jewish birthday we need to know the time of day.
School 
Grade Entering 
Hebrew Reading Proficiency 
 None  Somewhat  Well
Previous Jewish Education 
 Yes  No
Where? 
Does your child have any learning disabilities? Please specify 

This information will help us better cater to the needs of your child.
Family Information
My child is a 
Are the natural father, mother and maternal grandmother of the child Jewish?  Yes  No 
If no, please explain. 
Have there been any conversions or adoptions in the family?  Yes  No 
If yes, please explain. 
Parent Information
Father's Name Cell 
Email
Mother's Name 
Cell 
Email
Address 
City 
Zip 
Home Phone 
Synagogue Affiliation 
 
To enhance our curriculum we have school events and programs. 
Can you assist in event planning?
  
* Email allows us to communicate in the most efficient and economical manner. We do not use your address for other purposes.
Emergency Information
Emergency Contact 1 
Phone 
Relationship 
Emergency Contact 2 
Phone 
Relationship 
Family Physician 
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. 
Tuition Agreement
Tuition for the 2018-2019 school year is $800 per child including registration and book fee.

Discount: $30 discount before July 16.

Full payment plan must be submitted to the administration office before any child will be permitted to attend classes. 

Installments:  

Refer a friend and save 10% per family! (Friend must be new to Hebrew School and will be registering their child for this coming year) 
Name of Family Referring 
Payment Information
Payment Method   Checks can be mailed to Chabad of Homestead, 8460 SW 198th St, Miami Beach, FL 33189
Total Registration Cost   Card Number
Expiration   CVV
Additional Comments (optional):
Terms of Agreement
 I agree that in the event of an emergency, Chabad Hebrew School has my permission to arrange for any necessary first-aid or care by a licensed physician/first-aid worker. Chabad Hebrew School has my permission to use my child's photo in its publicity materials. I have completed the Enrollment Form and agree to pay any balance according to the terms of agreement oulined above.
Name: 
Initials: 

We look forward to a wonderful year of learning and growth!