Re-Enroll

Today's Date:

MonthDayYear

I/We are hereby re-enrolling my/our child/ren for the upcoming school year, on the Huntington Beach campus, subject to the terms of this contract, the general statements, rules, regulations, conditions, traditions and financial terms as indicated in our original application and contract of enrollment, in the parent/student handbook of community standards, academic standards, and calendar and fee schedule.

K-12 Registration Fee = $1100.00 per student.
Preschool Registration Fee $150 per student**

(Eligible discounts will apply)

Family Name

Primary Email

1a. Name of Student*

First NameLast Name

1b. Grade will be attending*

Enrolling additional children*

2a. Name of Student

First NameLast Name

2b. Grade will be attending

Enrolling additional children

3a. Name of Student

First NameLast Name

3b. Grade will be attending

Enrolling additional children

4a. Name of Student

First NameLast Name

4b. Grade will be attending

Enrolling additional children

5a. Name of Student

First NameLast Name

5b. Grade will be attending

Enrolling additional children

6a. Name of Student

First NameLast Name

6b. Grade will be attending

Enrolling additional children

7a. Name of Student

First NameLast Name

7b. Grade will be attending

I/We plan to enroll a child in Preschool*

YesNo

Preschool Registration Options

Full Day: 8:00 am - 3:30 pmHalf Day: 8:00 am - 12:25 pm

Full DaySelect all that apply

Half DaySelect all that apply

I / we plan to enroll a child in Kindergarten*

YesNo

How would you describe your child's personality?

What are your child's strengths?

Describe the educational environment you are seeking for your child?

What would you like us to know about your child?

What are your expectations of your child's Hebrew Academy educational experience?

How would you describe your child's academic performance to date?

Tell us about any special interests/ talents in music, art, religion, athletics, academics or other that your child has:

Describe any special requirements that your child may have (medications, allergies, dietary restrictions, etc.)

Please Check All*

1. My/Our re-enrollment contract and registration fee are accepted by the Hebrew Academy, contingent upon my/our child/ren’s maintenance of satisfactory marks, good citizenship and the above-stated rules. I/We understand that the re-enrollment contract and registration fee is required and that my/our present account must be paid in full in order for the Hebrew Academy to reserve a place for my/our child/ren.2. I/We hereby obligate for payment of the full year’s tuition and fees as per contract. Payment plan must be specified and post-dated checks or credit card submitted to reflect this schedule before my/our child/ren will be allowed to attend classes.3. I/We authorize the Hebrew Academy to send academic records and confidential recommendations to post-secondary schools and I/we will not seek access to confidential recommendations and evaluation materials. The undersigned releases the Hebrew Academy and its faculty and staff from any and all liability resulting from or pertaining to the furnishings of recommendations and records.4. The use of my/our child/ren’s photographs in school publications and inclusion of student information in school directories is authorized.5. A positive and constructive working relationship between the Hebrew Academy and a student’s parents/guardian is essential to the fulfillment of the Hebrew Academy’s educational purpose. I/We understand, therefore that the Hebrew Academy reserves the right not to extend the privilege of enrollment or re-enrollment to a student if the Hebrew Academy reasonably concludes that the actions of a parent/guardian make such a positive and constructive relationship impossible or otherwise seriously interfere with the Hebrew Academy’s accomplishment of its educational purpose.

Please Note: Transportation requests are filled on a first come first serve basis and are not included in tuition fees.

I/We are interested in transportation.*

YesNo

Bus Route*

Long BeachIrvine

Please Check One*

Please send me more information about bus routes, times, prices etc.Please plan for my child/ren to take the bus occasionally. There is no need for someone to check with me for ridership each day.Please assume my child/ren will be on the bus every day. I will call and inform the Hebrew Academy when my child/ren will not be on the bus.

The Hebrew Academy has a long tradition of offering financial aid to eligible families. The Board has established a process to apply for financial aid. Funding for financial aid is limited and will be distributed on a first come first serve basis.

Please Note: To qualify for Financial Aid a separate Financial Aid Application is required.

I/We plan to request Financial Aid.*K-12 only

YesNo

Contact for Financial Aid*Email or Phone

Has your contact information changed since your last registration?*

YesNo

Guardian 1

First NameLast Name

Guardian 2

First NameLast Name

I (We) would like to updatePlease check all that apply

Billing Address

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

Mailing Address (1)Guardian 1

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

Mailing Address (2)Guardian 2

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

Phone Number (1)Guardian 1

Area CodePhone Number

Phone Number (2)Guardian 2

Area CodePhone Number

E-mail (1)Guardian 1

E-mail (2)Guardian 2

Marital Status

Custody

Other

Registration FeeProcessing fee will be added to all credit card transactions. (AMEX - 4% , all other cards 3%) Eligible discounts will be applied.

Credit CardCheck

Credit Card Information

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Mailing Information:

Att: Registrar
Hebrew Academy
14401 Willow Lane
HB, CA 92647

Re-Enrollment Form

FAMILY AND STUDENT INFORMATION

Preschool

Kindergarten

Contract Terms

Transportation Request

Financial Aid Request

Contact Information

Payment Information

Thank you for choosing the Hebrew Academy!

LOWER SCHOOL

MIDDLE SCHOOL

HIGH SCHOOL