The Jewish Congregation of New Paltz
Student’s Name (1): ________________________________________________ DOB: _______________
First Middle Last
Please register my
child for the following Hebrew School Class/Grade _________________________
Is there anything about your child that you
would like us to know in order for him/her to have a more
positive
___________________________________________________________________________________________________________________
Student’s Name (2): ________________________________________________ DOB: _______________
First Middle Last
Please register my
child for the following Hebrew School Class/Grade _________________________
Is there anything about your child that you
would like us to know in order for him/her to have a more
positive
___________________________________________________________________________________________________________________
Parent/Guardian (1) _______________________________ Daytime Phone: _______________________
Address: _________________________________________ Home Phone:________________________
Street City
Zip
Email: ____________________________________________ Mobile Phone:_______________________
Occupation: _________________________________ Employer: ________________________________
*
May we email you as a method of contact for class announcements, information,
etc? Yes No
Parent/Guardian (2) _______________________________ Daytime Phone: _______________________
Address: _________________________________________ Home Phone:________________________
Street City
Zip
Email: ____________________________________________ Mobile Phone:_______________________
Occupation: _________________________________ Employer: ________________________________
*
May we email you as a method of contact for class announcements, information,
etc? Yes No
May we include the
above information in our published class lists? Yes No
May we contact you to
help out with Junior Congregation or