Re-Enrollment Form Today's Date: Month Day Year 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 FAMILY AND STUDENT INFORMATION Family Name Primary Email How many students will you be enrolling in grades K-12* 1a. Name of Student* First Name Last Name 1b. Grade will be attending* Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Enrolling additional children* Yes No 2a. Name of Student First Name Last Name 2b. Grade will be attending Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Enrolling additional children Yes No 3a. Name of Student First Name Last Name 3b. Grade will be attending Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Enrolling additional children Yes No 4a. Name of Student First Name Last Name 4b. Grade will be attending Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Enrolling additional children Yes No 5a. Name of Student First Name Last Name 5b. Grade will be attending Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Enrolling additional children Yes No 6a. Name of Student First Name Last Name 6b. Grade will be attending Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Enrolling additional children Yes No 7a. Name of Student First Name Last Name 7b. Grade will be attending Preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Preschool I/We plan to enroll a child in Preschool* YesNo How many children will you be enrolling in the Hebrew Academy Preschool* Preschool Registration Options Full Day: 8:00 am - 3:30 pmHalf Day: 8:00 am - 12:25 pm Full Day Select all that apply MondayTuesdayWednesdayThursdayFridayAM Extended CarePM Extended Care Half Day Select all that apply MondayTuesdayWednesdayThursdayFridayAM Extended Care Kindergarten I / we plan to enroll a child in Kindergarten* YesNo Did your child previously attend the Hebrew Academy Preschool? If not please specify the name of the preschool previously attended. Yes Student's Name First Name Last Name Date of Birth Month Day Year 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.)* Contract Terms 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. Transportation Request 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. Financial Aid Request 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 Contact Information Has your contact information changed since your last registration?* YesNo Guardian 1 First Name Last Name Guardian 2 First Name Last Name I (We) would like to update Please check all that apply Billing AddressMailing Address (Guardian 1)Mailing Address (Guardian 2)Mobile Phone (Guardian 1)Mobile Phone (Gaurdian 2)Email (Guardian 1)Email (Guardian 2)Marital StatusCustodyOther Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Mailing Address (1) Guardian 1 Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Mailing Address (2) Guardian 2 Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Phone Number (1) Guardian 1 Area Code Phone Number Phone Number (2) Guardian 2 Area Code Phone Number E-mail (1) Guardian 1 E-mail (2) Guardian 2 Marital Status Married Divorced Separated Other Custody Mother Father Joint Other Other Payment Information Total $0.00 Please note: Your re enrollment is pending until all forms are submitted and fees are paid. Our Admissions Team will review your submission and assist you with the completion process. You will receive a confirmation once everything is finalized. Thank you for choosing the Hebrew Academy! Submit Should be Empty: This page uses TLS encryption to keep your data secure.