Religious School Registration 2017 - 2018, Page 2
Forms are due August 1, 2017
Rel School Reg form #!
Please re-enter your Name (sorry for the inconvenience!)
Please re-enter your Primary Email (again, so sorry!)
Student's Name (English)
Student's Name (Hebrew)
Student's Cell Phone Number
Grade in September 2017
Please select a grade
Name of Public/Private School (Please spell out the entire name of the school.)
Township of School (ex: Lebanon, Raritan, etc.)
Was this student previously enrolled in Religious School at Or Chadash?
Yes, he/she was registered and attended last year
No, this is our first year registering
Please help us meet your child's needs by providing as much information as possible.
Please list any allergies or special medical needs we should be aware of - such as EpiPens.
Please also list any medication your child is taking or has taken in the last 6 months (if any).
Enter None if this child has no conditions we should be aware of in case of emergency
Is Student#1 up-to-date on his/her immunizations?
In order to create the most successful learning experience for your child, is your child currently receiving special services in their secular school (IEP/504 plans, classroom modifications, behavior plans, etc.) ?
None of the above
Please tell us about your child's special abilities, learning or behavioral difficulties and/or his/her best classroom learning style(s). Include items such as special needs in the classroom and abilities such as musical ability or acting skills:
To continue, please choose one of the following options:
I would like to register another child
I am finished, take me to the payment page
Do Not Fill This Out