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Kids ART & ALEF

Registration Form

REGISTRATION
2024 SPRING & SUMMER SESSION
MAY 15 - AUG 14

We are currently accepting application for the 2024 Spring & Summer program. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us at 310.544.5544

Please note that one registration form per child is needed.
We look forward to a wonderful year of learning and growth.
STUDENT PROFILE
Students Name*

First Name Last Name
Hebrew Name If known
Date of Birth*

Month Day Year
Gender*

BoyGirl
Grade Entering*
Previous Jewish Education*

YesNo
PARENTS INFORMATION
Father Name

First Name Last Name
Jewish by birth* Fathers Jewish Status

YesNo
Father Phone

Area Code Phone Number
Father E-mail
Mothers Name

First Name Last Name
Jewish by birth* Mothers Jewish Status

YesNo
Mother Phone

Area Code Phone Number
Mother E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

EMERGENCY CONTACT
Emergency Contact*

First Name Last Name
Phone*

Area Code Phone Number
Relation to Child*
PAYMENT
The Tuition fee is $360 for the Spring-Summer Session. There are two payment options.
1. A full payment of $360
2. Two installments of $180

Payments can be made by Credit Card or by Check. If you need financial assistance please choose "Financial Assistance Requested" and we will contact you regarding any scholarship opportunities
Payment Options

Charge my CC Full amountCharge my CC in 2 InstallmentsI'm paying the DepositFinancial Assitance Needed
Total

$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

Should be Empty:

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