How many students registering?* Student Information Full Name* First Name Last Name E-mail Hebrew Name Grade Entering* Has your address or any of your contact information changed since last year?* YesNo Please update Sibling Information Sibling 1 Full Name First Name Last Name Sibling 1 Hebrew Name Sibling 1 Grade Entering Sibling 2 Full Name First Name Last Name Sibling 2 Hebrew Name Sibling 2 Grade Entering Sibling 3 Full Name First Name Last Name Sibling 3 Hebrew Name Sibling 3 Grade Entering Sibling 4 Full Name First Name Last Name Sibling 4 Hebrew Name Sibling 4 Grade Entering Sibling 5 Full Name First Name Last Name Sibling 5 Hebrew Name Sibling 5 Grade Entering Tuition Sundays 10:00 AM - 12:00 PM Registration Fee: $100 Security Fee: $100 Tuition: $700 Total Full Price: $900 Registration & book fee must be paid in full at time of registration and are not included in tuition fees. Payment Methods You may choose from the following payment methods: The tuition can be paid in full when registering your child. Alternatively, it could be broken up into three equal payments over 3 months. •Head-checks dated for each of these dates are due at registration. Please make all checks payable to Chabad South Broward Youth and submit them together with the registration form •Tuition refunds will not be granted to children withdrawing from school after November 1st. •There are no refunds or credits for days missed due to illness, holidays, or family vacations. Billing Information Payment Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Payment Plan Pay in FullSplit in 3 payments I would like to assist a child who cannot afford Hebrew School Education. YesNo Amount $18$36$54$72$180$360$500$720 Total $0.00 I would like to receive news and updates by email Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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