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Registration

Student Information
CHILD 1
Last Name
First Name
Hebrew Name
Gender
Male Female
Date of Birth
School
Grade
Previous Jewish education?
Yes No
If Yes please describe
Medical challenges or allergies? 
Yes No
If Yes please explain
Hebrew Reading Level 
 Beginner
 Somewhat
 Expert
CHILD 2
Last Name
First Name
Hebrew Name
Gender
Male Female
Date of Birth
School
Grade
Previous Jewish education?
Yes No
If Yes please describe
Medical challenges or allergies?
Yes No
If Yes please explain
Hebrew Reading Level 
 Beginner
 Somewhat
 Expert 
CHILD 3
Last Name
First Name
Hebrew Name
Gender
Male Female
Date of Birth
School
Grade
Previous Jewish education?
Yes No
If Yes please describe
Medical challenges or allergies?
Yes No
If Yes please explain
Hebrew Reading Level 
 Beginner
 Somewhat
 Expert 
Parent Information
Marital Status
Affiliation
 
Father
Title/First Name
Last Name
Work Phone
Cell Phone
Email 

Jewish  Yes  No
Converted  Yes  No

Mother
Title/First Name
Last Name
Work Phone
Cell Phone
Email 
Jewish  Yes  No
Converted  Yes  No
Parents
Address
City/State/ Zip
Home Phone
If there have been any conversion or adoptions in the family please provide details.
If yes please explain
Emergency Information
Emergency 1
Name
Phone #
Relation
Emergency 2
Name
Phone #
Relation
Tuition Fees

Classes are held on Sundays at Chabad Jewish Center of Petaluma 10:00 AM - 12:00 PM

Child One - $650.00 • Child Two - 10% Off

Scholarship Fund

Every Jewish child deserves a quality education. Contact us at 707.559.8585 and we will be glad to help.

If you are in the position to contribute to the scholarship fund, please consider doing so below.

 $180      Half Scholarship - $325      Full Scholarship - $650       Other amount $ 
Payment Information
Please Choose Payment Plan
Please Choose Payment Method
Card Number
Name on Card
Expiration Date
Security Code
What's This?
Billing Address
Billing Zip

-Enrollment and acceptance in Petaluma Hebrew is in no way a validation of one’s status as a Jew- 

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Registration
Now accepting registration for 2018-2019
Petaluma Hebrew opens in October 2018
Upcoming events
 
WHERE JUDAISM COME ALIVE!