The Hebrew Academy - A Yeshiva Day School serving Toddler through Eighth Grade

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Prospective Student Preliminary Application Form

How many legal Guardians are there in this household*

Single Parent\Guardian2 Parent\Guardian Invalid Input

How Many Students are you enrolling*

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Parent/Legal Guardian #1

Title*

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First Name*

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Last name*

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Hebrew Name*

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Have there been any conversions or adoptions in the family?*

YesNo Invalid Input

Who?*

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Address*

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City*

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State*

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Zip Code*

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Home Phone*

Please enter a Valid Phone Number

Please enter your 10 digit phone number.

Cell Phone

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Please enter your 10 digit phone number.

Work Phone

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Please enter your 10 digit phone number.

Email*

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Occupation*

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Marital Status*

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Synagogue Affiliations*

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Relationship to Student*

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Parent/Legal Guardian #2

Title*

Invalid Input

First Name*

Invalid Input

Last Name*

Invalid Input

Hebrew Name*

Invalid Input

Have there been any conversions or adoptions in the family?*

YesNo Invalid Input

Who?*

Invalid Input

Address*

Invalid Input

City*

Invalid Input

Sate*

Invalid Input

Zip Code*

Invalid Input

Home Phone*

Invalid Input

Please enter your 10 digit phone number.

Cell Phone

Invalid Input

Please enter your 10 digit phone number.

Work Phone

Invalid Input

Please enter your 10 digit phone number.

Email*

Invalid Input

Occupation*

Invalid Input

Marital Status*

Invalid Input

Synagogue Affiliations*

Invalid Input

Relationship to Student*

Invalid Input

How did you hear about The Hebrew Academy?*

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Family Name*

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How?*

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Payment Options*

It is required and may not be left blank

Please note: Your application is not complete until we have received your registration fees.

If you select Credit Card, you will have the opportunity to pay when you submit this form. If you select Check or Cash, please send your payment to The Hebrew Academy, 315 N. Main Street, New City, NY, 10956 Attn: Admissions.

I\We are interested in applying for Traditional Financial Aid

I\We are interested in applying for the Quick Track Tuition Credit

I\We qualify for the Discover The Hebrew Academy Grant

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Please check the box in lieu of a Signature *

Parent 1 Invalid Input

Please check the box in lieu of a Signature *

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The Hebrew Academy - A Yeshiva Day School serving Toddler through Eighth Grade

Prospective Student Preliminary Application Form

Admissions

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