TBA Religious School Registration Non-member 2023-24

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Email address

Student's First Name

Student's Last Name

Student's Hebrew Name

Please include the child’s Hebrew name. If you do not know it or if the child does not have one, please contact Rabbi Adler at 978-927-3211, ext.5, or rabbi.adler@tbabeverly.org

Date of Birth

Grade as of September 2023

* Is this your child's first year at TBA Religious School?

Please Select OneYesNo

Parent's Full Name

Parent's Hebrew Name

Parent's Full Name

Parent's Hebrew Name

Address

* May we add your child’s name & family’s contact information to the school directory?

Please Select OneYesNo

* May we use your child’s photograph for promotional purposes (brochures, web, etc)?

Please Select OneYesNo

Home Phone

Cell Phone

If parents are divorced or separated, please complete the following:

Custodial Parent's Full Name

Do you wish all mailings regarding the child go to both parties?

YesNo

If you are new to our TBA learning program, please tell us about your child's strengths, interests, or any challenges that would help us to get to know them better.

Sat, July 27 2024 21 Tammuz 5784

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