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Dead Forms Aleph Champ Plus!

Aleph Champ Plus! 2019/20 Registration

Please fill out one form per student
Students Name:*

First Name Last Name
Age:*
Grade:*
Hebrew Reading Experience:*

Yes No
Parent 1:*

First Name Last Name
Parent 2:

First Name Last Name

Address*

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

E-mail*
Phone Number*

Area Code Phone Number
Emergency Contact*

First Name Last Name
Relation to Student*
Phone Number*

Area Code Phone Number
Pricing:

Chabad Hebrew School of the Arts Student - $300 Chabad Hebrew School of the Arts Student + Chai Club Member - $270 Aleph Champ Plus Student - $450 Aleph Champ Plus Student + Chai Club Member - $405
Total

$0.00

I would like to pay today: Full amount 50% minimum: $0.00 $

Payment

Credit Card Check

Postal / Zip Code

Country

Should be Empty:

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