This form must be completed for each child enrolled in our Hebrew School.

Primary Contacts are the email/phone numbers you would like contacted first should the need arise.

Child's Name *

First

Last

Parent #1 Name *

First

Last

Parent #2 Name

First

Last

Parent #1 Email (Primary Contact Address) *

Parent #2 Email

Parent #1 Phone (Primary Contact) *

Parent #2 Phone

Child's Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Applicable Discounts

I am a member of ACI
I am enrolling a sibling to ACI's Hebrew School

Membership discount is only applied when all membership dues for the active year are to-date.

Child's Hebrew Name

Child's Grade Level

Child's School Name

Child's School Phone Number

School Dismissal Time

Please enter the time the child's school is dismissed on Tuesdays.

Allergies (If any we need to know about)

If this is your child's first year at ACI, describe their familiarity with the Hebrew alphabet and exposure to customs and traditions.

Describe a successful learning environment for your child.

Please list all persons who are approved to pickup your child from ACI (first and last name.) To edit this list, please contact the office.

Pickup

Person #1

Relationship #1

Pickup

Person #2

Relationship #2

Pickup

Person #3

Relationship #3

Pickup

Person #4

Relationship #4

Photo Release
I hereby grant permission to Astoria Center of Israel and its representatives, to take and use: photographs and/or digital images of my child for use in promotional materials. These materials might include printed or electronic publications, web sites, or other electronic communications. I further agree that my child’s name and identity will not be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of Astoria Center of Israel.

I agree to the photo release terms.
I decline the photography consent.

What happens next?
Once we've processed your enrollment, we will contact you for the first payment which secures your place for the 2024/2025 school year. Enrollment is not finalized until the first payment is received.

For the 2024/2025 school year non-member tuition will remain $1,250, member tuition will be $950, and the sibling discount is 10%.

How would you like our office to setup your payments?

The entire tuition amount, in full.
Please setup monthly payments for my tuition.
Please contact me about financial aid.

What is your preferred payment method?

Zelle - No Service Fees!
Credit Card (Online)
Check to the office

Paying with Zelle is simple and easy! Every single US-based bank includes a simple function to send money quickly and securely via Zelle. Our Zelle address is [email protected]. Learn more here.