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Youth Aleph Champ Plus!

Aleph Champ Plus! 2019/20 Registration

Please fill out one form per student
Students Name:*
First NameLast Name
Age:*
Grade:*
Hebrew Reading Experience:*
YesNo
Parent 1:*
First NameLast Name
Parent 2:
First NameLast Name

Address*

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

E-mail*
Phone Number*
Area CodePhone Number
Emergency Contact*
First NameLast Name
Relation to Student*
Phone Number*
Area CodePhone Number
Pricing:
Chabad Hebrew School of the Arts Student - $300Chabad Hebrew School of the Arts Student + Chai Club Member - $270Aleph Champ Plus Student - $450Aleph Champ Plus Student + Chai Club Member - $405
Total
$0.00

I would like to pay today: Full amount50% minimum: $0.00 $

Payment

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Postal / Zip Code

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