<!DOCTYPE HTML PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">

<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<head>
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="Content-Language" content="en" />

<meta name="keywords" content="Chabad,Hebrew,School,Registration,Form" />
<meta name="title" content="Chabad Hebrew School Registration Form - Chabad of North Brooklyn" />
<meta property="og:type" content="website" />
<meta name="scope-aids" content="213241-213248-2901920-2923026-4496416" />
<meta name="article-keywords" content="2185-6760-2170-2898" />
<meta name="scope-aid" content="213241" />
<meta name="scope-aid" content="213248" />
<meta name="scope-aid" content="2901920" />
<meta name="scope-aid" content="2923026" />
<meta name="scope-aid" content="4496416" />
<meta name="article-keyword" content="2185" />
<meta name="article-keyword" content="6760" />
<meta name="article-keyword" content="2170" />
<meta name="article-keyword" content="2898" />
<meta property="og:url" content="https://www.chabadofnorthbrooklyn.com/templates/articlecco_cdo/aid/4496416/jewish/Chabad-Hebrew-School-Registration-Form.htm" />
<meta property="twitter:card" content="summary_large_image" />
<meta property="twitter:site" content="@chabad" />
<meta property="og:title" content="Chabad Hebrew School Registration Form - Chabad of North Brooklyn" /><link rel="canonical" href="https://www.chabadofnorthbrooklyn.com/templates/articlecco_cdo/aid/4496416/jewish/Chabad-Hebrew-School-Registration-Form.htm" />
<link rel="Stylesheet" href="/css/fonts/font-awesome/font-awesome-5.css?g=20&v=98662BF4" id="kfont-awesome" type="text/css"/>
<link rel="Stylesheet" href="/css/DefaultGrid.css?g=20&v=44B79007" id="kgrid" type="text/css"/>
<link rel="Stylesheet" href="/css/Elements.css?g=20&v=E669C926" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/vendor/ds/tokens/sites.css?g=20&v=D77AD1C0" id="ksites-ds-css" type="text/css"/>
<link rel="Stylesheet" href="/css/new/main.css?g=20&v=2B7F734E" id="k7" type="text/css"/>
<link rel="Stylesheet" href="/css/global.css?g=20&v=D37C5613" id="k3" type="text/css"/>
<link rel="Stylesheet" href="/css/global-print.css?g=20&v=1FE80AC1" id="k5" type="text/css" media="print"/>
<link rel="Stylesheet" href="/css/cco/home/widget-styles.css?g=20&v=B14CEBA0" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/template5/global.css?g=20&v=1F4BAE3C" id="k" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/template5/skins/default.css?g=20&v=89C05F2D" id="k" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/home/default/skin.css?g=20&v=E137E26C" id="k" type="text/css"/>
<link rel="Stylesheet" href="/css/old/global.css?g=20&v=F7C22456" id="k2898" type="text/css"/>
<link rel="Stylesheet" href="/css/bootstrap/grid.css?g=20&v=B92FCAD8" id="kbootstrap4-grid" type="text/css"/>
<link rel="Stylesheet" href="/css/Library/reader-comments.css?g=20&v=5F31D0D8" id="kCommentsStylesheet" type="text/css"/>
<link rel="Stylesheet" href="/css/inline/BookInfo.css?g=20&v=14B88022" id="kBookInfoCss" type="text/css"/>
<!--[if lte IE 8]> <link rel="Stylesheet" href="/css/global-ie.css?g=20&v=E699B0F3" id="k4" type="text/css"/> <![endif]-->
<script>$q=[];$j=function(f){$q.push(f);}</script>
	
<title>
	Chabad Hebrew School Registration Form - Chabad of North Brooklyn 
</title>
	



<script>
	window.dataLayer = window.dataLayer || [];
	dataLayer.push({"event":"datalayer-initialized","page":{"numberOfComments":0,"publicationDate":"2020-01-15","primaryArticleId":4496416,"title":"","author":"","authorId":0,"contentLevel1":"My Site","contentLevel2":"Archives","contentLevel3":"Past Events","contentLevel4":"Chabad Hebrew School Registration Form","siteName":"Chabad of North Brooklyn "},"time":{"upcomingHoliday":"The Three Weeks","daysToUpcomingHoliday":37,"hebrewDate":"5786-03-10"}});
		dataLayer.push({ 'articleHierarchy': '-213241-213248-2901920-2923026-4496416-', 'keywords': '-k2898-k2170-k6760-k2185-', 'k': '-213241-213248-2901920-2923026-4496416--k2898-k2170-k6760-k2185-' });
	
</script>
<script>

(function(c,h,a,b,a,d){c[a]=c[a]||[];c[a].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=h.getElementsByTagName(b)[0],
j=h.createElement(b);j.async=true;
j.src='https://w6.chabad.org/mitzvah-tank.js';f.parentNode.insertBefore(j,f);
})(window,document,0,'script','dataLayer');</script>

	<!-- Start of StatCounter Code -->
	<script type="text/javascript">
	var sc_project = 1076295;var sc_partition = 1;var sc_invisible = 1;var sc_remove_link=1;var sc_security = "f6f9dee5";var sc_https = 1;
	</script>
	<script type="text/javascript" src="https://secure.statcounter.com/counter/counter_xhtml.js" defer async></script>
	<noscript><img src="//c2.statcounter.com/counter.php?sc_project=1076295&amp;java=0&amp;security=f6f9dee5&amp;invisible=1" border="0" /> </noscript>
	<!-- End of StatCounter Code -->


<style type="text/css"> 
	body { 
	background: url(https://w2.chabad.org/media/images/886/oNru8865227.jpg) top center repeat-x fixed !important; 
	} 
	.LO_top_bg {background:none!important} 
	#cco_body_wrap {background-image:none!important} 
	
	body .site_title,body.cco_body .site_title{ 
	height: 140px; 
	width:100%; 
	color:transparent; 
	background:url(https://w2.chabad.org/media/images/887/bXoh8878094.png) no-repeat center 100%; 
	padding-top: 0; 
	margin-bottom: 0; 
	}
.cco_search_header {float:right}
body.cco_body #tabContentMain .co_menu_item span.parent a {width:100px}
</style>

<link href="https://clickconsultingservices.github.io/holiday-minisites/highholidays/style.css" rel="stylesheet" type="text/css">
</head>
<body class="lang_en dir_ltr cco_body form secure">

	


	
	<div id="PrintCreditHeader" class="show_for_print">
Printed from<b>ChabadofNorthBrooklyn.com</b>
</div>
	<div id="header">
		<div class="wrapper">
			
<div id="feedback_bar" class="hide_for_print no_outline">
	<div class="wrapper">
		
	</div>
</div>

			


<div id="header_container" class="header_container">
	<div class="clearfix links">
		<img src="https://w2.chabad.org/images/global/spacer.gif" width="15" height="8" class="baruch_hashem" />
		<div class="float_right">
			
			
				<div class="topBarLink cco_topbar_link ask_the_rabbi_link">
					<a href="/asktherabbi/default_cdo/jewish/Ask-the-Rabbi.htm">Ask the Rabbi</a>
				</div>
				
			
				<div id="HeaderSubscribe" class="top_bar_item topBarLink cco_topbar_link subscribe_link">Subscribe
					<div id="HeaderSubscribeContainer" class="topBarLayer" style="display:none;width:295px;">
						<div id="SubscribeFormContainer">
							<span id="SubscribeMessage" class="error" style="display:none;"></span>
							<form name="topSubscribe54b2c7d9e6" class="subscribe_box" target="" action="" method="get" onsubmit="return submitHeaderSubscribe(this, document.getElementById('54b2c7d9e6FormContainer'), document.getElementById('54b2c7d9e6ResponseContainer'));">



<script>
	var recaptchaIsEnterprise = false;
		 var recaptchaV2Key = "6LcG_TcUAAAAAKAVgwgW39ujc9OCjXSoQYFIA-Su";

</script>

	<input type="hidden" class="js-recaptcha-input" name="cdo-captcha-response" value="" data-div-id="796442a0-b8b9-458d-949d-fbc7303e7818" data-processed="false" />
	<div class="js-recaptcha-wrapper" id="796442a0-b8b9-458d-949d-fbc7303e7818"></div>	

<div class="container horizontal_padding" id="54b2c7d9e6Container">
<div style="margin:10px 0;">
<div class="co_form_container" id="54b2c7d9e6FormContainer">
<input type="text" maxlength="50" class="co_global_input float_left medium_bottom_margin" value="" required="" display_name="First Name" id="Fname" name="fname" placeholder="First Name">
<input type="text" maxlength="50" class="co_global_input float_right medium_bottom_margin" value="" required="" display_name="Last Name" id="Lname" name="lname" placeholder="Last Name">
<div class="form_group">
<input type="hidden" name="via" value="inlineSubscribeBox:2371860;" />
<input type="text" class="co_global_input medium_bottom_margin" value="" required="" display_name="Email" id="SubscribeEmail" name="email" placeholder="Email Address">
<div id="CoButton_wrapper" class="co_global_submit" style="width:100%;padding:0;"><button id="CoButton" type="submit" class="button" value="Subscribe"><span>Subscribe</span></button></div>
</div>
<div class="break_floats"></div>
<div class="light_grey f-small" style="padding-top:3px;padding-left:3px;">
<input type="hidden" name="subscriptionid" value="80" />
Subscribe to ChabadCityCentre.com Updates
</div>
</div>
<div id="54b2c7d9e6ResponseContainer"></div>
</div>
</div>
</form>
<!-- END CACHE -->
							<div class="break_floats"></div>
						</div>
						<div class="blue f-small bold small_vertical_padding medium_horizontal_padding footer_box">
							<a href="/tools/subscribe/default_cdo">View all subscriptions &raquo;</a>
						</div>
					</div>
				</div>
			
			
				<div class="topBarLink cco_topbar_link contact_link">
					<a href="/tools/feedback.asp">Contact</a>
				</div>
			
			
		</div>
		<div class="float_left">
			
				<div class="topBarLink cco_topbar_link home_link">
					<a href="/">Home</a>
				</div>
				
			
			
			
			
				<div class="topBarLink">
					

<div id="loginHeaderContainer" class="">
	
</div>

				</div>
			
		</div>
	</div>
	<div class="break_floats"></div>
</div>

			<div id="header_container" class="clearfix">
				<div id="header_branding" class="no_outline ">
					<div class="g260 no_margin cco_search_header float_right">
						

<div class="co_search_form margin05">
	<form name="MainSearchForm" id="MainSearchForm" method="get" action="/search/results.asp" class="clearfix" onsubmit="return Co.Forms.Validation.Validate(this, null, {markAsSubmitted:false});">
		<div class="co_global_submit"><button type="submit" class="button" value=" "><span> </span></button></div>
		

<div class="co_global_input_container clearfix">
	<input id="topAreaTopSearch_search" required="true" autocomplete="nope" placeholder="Search" value="" OnAutoSuggestSelect="OnSearchAutoSuggestSelect(ev);" class="co_global_input co_search js-search-field active js-mirrored-input" onblur="this.form.className = this.form.className.replace(/\sactive/gi, &#39;&#39;);" name="searchWord" onfocus="this.form.className+=&#39; active&#39;;" type="text" autoSuggestProperties="&quot;Highlight&quot;:true,&quot;Name&quot;:&quot;topAreaTopSearch_search&quot;,&quot;AutoSubmit&quot;:true,&quot;ShowRecommendedOnTop&quot;:false" autoSuggestUrl="/WebServices/RemoteCall/Get_Suggestions" display_name="Search Field" min_length="3"></input>
</div>

			
		
		
	
		<div id="topAreaTopSearch_search_wrapper" class="co_field_options" style="display:none;">
			<div class="co_absolute_wraper" id="co_absolute_wraper" style="">
				<div class="inner">
					<div id="topAreaTopSearch_search_container" class="co_field_options_suggestions"></div>
					<div class="break_floats"></div>
					
				</div>
			</div>
		</div>
	</form>
</div>
					</div>
					
					<a href="/default.asp" title="Chabad of North Brooklyn " class="site_title" style="margin-left:15px;">Chabad of North Brooklyn <span class="site_subtitle clearfix"> </span></a>
				</div>
			</div>
			
			
			<script>
var primaryNavigationVersion = "631636776000000000";
</script>
<div id="co_menu_container_wrapper" class="co_menu_container_wrapper desktop-only" data-list-name="primary navigation"> 
<div class="co_menu_container clearfix" id="co_menu_container">
<a class="menu_logo" href="/"></a>
<table cellpadding="0" cellspacing="0" border="0" class="main_menu_container first global">
<tr id="tabContentMain" tab="Main" style="display:table-row;">
<td class="co_menu_item home" data-menu-level="1"><a href="/default.asp"><img class="co_menu_home_image" src="https://w2.chabad.org/images/global/spacer.gif" width="28" height="60" border="0" onmouseover="this.className += ' hover';" onmouseout="this.className=this.className.replace(/\s?hover/gi, '');" /></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="2922892" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="http://www.charidy.com/chabadnorthbrooklynbrighter" class="item empty" id="menu_item1-1" data-menu-level="2" data-aid="7176437">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>SHINE BRIGHTER - MATCHING CAMPAIGN 2025</span>
</a>
</div>
<div id="menu_child1-1" class="menu_child empty selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/2922892/jewish/About.htm" class="parent">About</a></div></span><a href="/templates/articlecco_cdo/aid/2922892/jewish/About.htm" class="bg_extension js-parent-menu-link" data-aid="2922892"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="2922870" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/articlecco_cdo/aid/4878394/jewish/Rosh-Hashana-5786-Schedule.htm" class="item hover selected" id="menu_item2-1" data-menu-level="2" data-aid="4878394">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Rosh Hashana 5786 - Schedule</span>
</a>
<a href="/templates/articlecco_cdo/aid/562924/jewish/Mezuza-Tefillin.htm" class="item empty selected" id="menu_item2-2" data-menu-level="2" data-aid="562924">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Mezuza & Tefillin</span>
</a>
<a href="/templates/articlecco_cdo/aid/2369014/jewish/Synagogue-Services.htm" class="item empty selected" id="menu_item2-3" data-menu-level="2" data-aid="2369014">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Synagogue & Services</span>
</a>
<a href="/templates/articlecco_cdo/aid/2922896/jewish/Kiddush-Sponsorship.htm" class="item empty selected" id="menu_item2-4" data-menu-level="2" data-aid="2922896">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Kiddush Sponsorship</span>
</a>
<a href="/templates/articlecco_cdo/aid/5251027/jewish/Building-Campaign.htm" class="item empty selected" id="menu_item2-5" data-menu-level="2" data-aid="5251027">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Building Campaign</span>
</a>
<a href="/templates/articlecco_cdo/aid/7236290/jewish/RSVP-to-Shabbat-Meals.htm" class="item empty selected" id="menu_item2-6" data-menu-level="2" data-aid="7236290">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>RSVP to Shabbat Meals</span>
</a>
</div>
<div id="menu_child2-1" class="menu_child selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/4878942/jewish/Kids-Rosh-Hashana-at-the-Waterfront-2025.htm" class="child_item default" data-menu-level="3" data-aid="4878942"><span>Kids Rosh Hashana at the Waterfront 2025</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-2" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-3" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-4" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-5" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-6" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/2922870/jewish/Synagogue-Services.htm" class="parent">Synagogue&nbsp;&<br />Services</a></div></span><a href="/templates/articlecco_cdo/aid/2922870/jewish/Synagogue-Services.htm" class="bg_extension js-parent-menu-link" data-aid="2922870"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="2901921" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/section_cdo/aid/2293959/jewish/Gan-Chabad-Preschool.htm" class="item hover" id="menu_item3-1" data-menu-level="2" data-aid="2293959">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Gan Chabad Preschool </span>
</a>
<a href="/templates/section_cdo/aid/2530048/jewish/Camp-Gan-Israel.htm" class="item" id="menu_item3-2" data-menu-level="2" data-aid="2530048">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Camp Gan Israel</span>
</a>
<a href="/templates/articlecco_cdo/aid/562934/jewish/JAMS-Judaism-through-Art-Music-and-Science.htm" class="item" id="menu_item3-3" data-menu-level="2" data-aid="562934">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>JAMS-Judaism through Art, Music, and Science</span>
</a>
<a href="/templates/articlecco_cdo/aid/5867562/jewish/Naomis-Library.htm" class="item empty" id="menu_item3-4" data-menu-level="2" data-aid="5867562">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Naomi's Library</span>
</a>
<a href="/templates/articlecco_cdo/aid/5930314/jewish/Thursday-Tot-Shabbat-Spring-Session-2026.htm" class="item empty" id="menu_item3-5" data-menu-level="2" data-aid="5930314">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Thursday Tot Shabbat Spring Session 2026</span>
</a>
<a href="/templates/articlecco_cdo/aid/6670093/jewish/Bat-Mitzvah-Club-2026.htm" class="item empty" id="menu_item3-6" data-menu-level="2" data-aid="6670093">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Bat Mitzvah Club 2026</span>
</a>
</div>
<div id="menu_child3-1" class="menu_child selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/2293960/jewish/About-Us.htm" class="child_item default" data-menu-level="3" data-aid="2293960"><span>About Us</span></a>
<a href="/templates/articlecco_cdo/aid/2293961/jewish/Curriculum.htm" class="child_item default" data-menu-level="3" data-aid="2293961"><span>Curriculum</span></a>
<a href="/templates/articlecco_cdo/aid/2293962/jewish/Programs.htm" class="child_item default" data-menu-level="3" data-aid="2293962"><span>Programs</span></a>
<a href="/templates/articlecco_cdo/aid/2293963/jewish/Admissions.htm" class="child_item default" data-menu-level="3" data-aid="2293963"><span>Admissions</span></a>
<a href="/templates/articlecco_cdo/aid/2300303/jewish/Photos.htm" class="child_item default" data-menu-level="3" data-aid="2300303"><span>Photos</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-2" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/2530052/jewish/Photos.htm" class="child_item default" data-menu-level="3" data-aid="2530052"><span>Photos</span></a>
<a href="/templates/articlecco_cdo/aid/2530054/jewish/Dates-Rates.htm" class="child_item default" data-menu-level="3" data-aid="2530054"><span>Dates & Rates</span></a>
<a href="/templates/articlecco_cdo/aid/5865794/jewish/Online-Registration-Request.htm" class="child_item default" data-menu-level="3" data-aid="5865794"><span>Online Registration Request</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-3" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/6086872/jewish/JAMS-CHABAD-HEBREW-SCHOOL-SPRING-2026.htm" class="child_item default" data-menu-level="3" data-aid="6086872"><span>JAMS CHABAD HEBREW SCHOOL- SPRING 2026</span></a>
<a href="/templates/photogallery_cdo/aid/5869019/jewish/JAMS-Photos.htm" class="child_item default" data-menu-level="3" data-aid="5869019"><span>JAMS Photos</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-4" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-5" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-6" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/2901921/jewish/Children-Youth.htm" class="parent">Children<br />&&nbsp;Youth</a></div></span><a href="/templates/articlecco_cdo/aid/2901921/jewish/Children-Youth.htm" class="bg_extension js-parent-menu-link" data-aid="2901921"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="2923025" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/articlecco_cdo/aid/2923027/jewish/Jewish-Calendar.htm" class="item empty" id="menu_item4-1" data-menu-level="2" data-aid="2923027">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Jewish Calendar</span>
</a>
</div>
<div id="menu_child4-1" class="menu_child empty selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/2923025/jewish/Upcoming-Events.htm" class="parent">Upcoming<br />Events</a></div></span><a href="/templates/articlecco_cdo/aid/2923025/jewish/Upcoming-Events.htm" class="bg_extension js-parent-menu-link" data-aid="2923025"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item" aid="2901924" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/templates/articlecco_cdo/aid/2901924/jewish/Donate.htm" class="parent">Donate</a></div></span><a href="/templates/articlecco_cdo/aid/2901924/jewish/Donate.htm" class="bg_extension js-parent-menu-link" data-aid="2901924"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="7236215" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/articlecco_cdo/aid/7236221/jewish/Hotels-Nearby.htm" class="item empty selected" id="menu_item6-1" data-menu-level="2" data-aid="7236221">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Hotels Nearby</span>
</a>
<a href="/templates/articlecco_cdo/aid/7236222/jewish/Kosher-Food.htm" class="item empty selected" id="menu_item6-2" data-menu-level="2" data-aid="7236222">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Kosher Food</span>
</a>
<a href="/templates/articlecco_cdo/aid/7236226/jewish/Shabbat-Minyan.htm" class="item empty selected" id="menu_item6-3" data-menu-level="2" data-aid="7236226">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Shabbat & Minyan</span>
</a>
<a href="/templates/articlecco_cdo/aid/7236227/jewish/Womens-Mikvah.htm" class="item empty selected" id="menu_item6-4" data-menu-level="2" data-aid="7236227">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Women's Mikvah</span>
</a>
</div>
<div id="menu_child6-1" class="menu_child empty selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child6-2" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child6-3" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child6-4" class="menu_child empty" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/7236215/jewish/Visitors-Information.htm" class="parent">Visitors<br />Information</a></div></span><a href="/templates/articlecco_cdo/aid/7236215/jewish/Visitors-Information.htm" class="bg_extension js-parent-menu-link" data-aid="7236215"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item" aid="562922" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/templates/articlecco_cdo/aid/562922/jewish/Classes-Workshops.htm" class="parent">Classes&nbsp;&<br />Workshops</a></div></span><a href="/templates/articlecco_cdo/aid/562922/jewish/Classes-Workshops.htm" class="bg_extension js-parent-menu-link" data-aid="562922"></a></td>
</tr>
</table>
</div>
</div>
<!-- END CACHE -->
		</div>
	</div>
	<div id="content">
		<div id="BodyContainer" class="wrapper">
			<div class="body_wrapper  clearfix">
				
	<div class="co_content_container clearfix local_content" id="co_content_container">
		<div class="clearfix">
			
			
			
			<div class="clearfix bh mobile-only align_right">ב"ה</div>
			
				<div class="master-content-wrapper g960" >
					

<header class="article-header cf ">
	
<script type="application/ld+json">
{
	"@context": "http://schema.org",
	"@type": "BreadcrumbList",
	"itemListElement": [
  {
    "@type": "ListItem",
    "position": 1,
    "item": {
      "@id": "/templates/articlecco_cdo/aid/2901920/jewish/Archives.htm",
      "name": "Archives"
    }
  },
  {
    "@type": "ListItem",
    "position": 2,
    "item": {
      "@id": "/templates/articlecco_cdo/aid/2923026/jewish/Past-Events.htm",
      "name": "Past Events"
    }
  },
  {
    "@type": "ListItem",
    "position": 3,
    "item": {
      "@id": "/article.asp?aid=4496416",
      "name": "Chabad Hebrew School Registration Form"
    }
  }
]
}
</script>
<div class="breadcrumbs breadcrumbs hide_for_print" data-list-name="breadcrumbs">
	
			<a class="breadcrumbs__crumb" href='/templates/articlecco_cdo/aid/2901920/jewish/Archives.htm' data-aid="2901920">
				Archives
			</a>
		<span class="breadcrumbs__divider fa fa-angle-end"></span>
			<a class="breadcrumbs__crumb" href='/templates/articlecco_cdo/aid/2923026/jewish/Past-Events.htm' data-aid="2923026">
				Past Events
			</a>
		
</div>
	
			<h1 class="article-header__title js-article-title js-page-title">Chabad Hebrew School Registration Form</h1>
		
			<div>
				
			</div>
		
</header>
				</div>
			
			<div class="body_wrapper clearfix co_body">
				<div class="g960" id="co_body_container">
					
					<div id="ContentBody">
						
						
							<div class="content-area-parent no_margin">
								
	<div id="cco_body">
		<div class="content g960 no_margin no_overflow" id="co_content_container">
			
			
	

	<article class="content js-content" >
	


		<form 
			autocomplete="off" 
			action="/templates/articlecco.asp?aid=4496416" 
			method="post" id="form1" 
			
			onSubmit="return Co.Forms.Validation.Validate(this);">
			<input type="hidden" name="site" value="">
			<input type="hidden" name="sc" value="">
		
			<div >
				<co:body xmlns:co="www1.chabadonline.com/alpha1" xmlns:ext="urn:xslt-extensions">
  <div class="co_body article-body cf">
<div id="formBody">
      <p style="text-align: center;"><img src="https://w2.chabad.org/media/images/1047/xXiz10477421.jpg" alt="CHABAD HEBREW SCHOOL.jpg" real_width="663" real_height="858" border="0" width="400" height="518"> </p>
<p style="text-align: center;">
<span style="color: rgb(0, 0, 128); font-family: Verdana; font-size: 16px;">CHABAD HEBREW SCHOOL - Awesome Jewish afterschool program!<br>
<em>Serving the Williamsburg &amp; Greenpoint Communities  </em><br>
</span></p>
<p class="Remove" style="text-align: center;"><span style="font-family: Verdana;">
<span style="color: rgb(0, 0, 128); font-family: verdana; font-size: 16px;">GRADES KDG and up <br>
</span><span style="color: rgb(0, 0, 128); font-family: verdana;">
<strong><span style="font-family: verdana; font-size: 16px;"><br>
</span></strong><u>
<span style="font-family: verdana;"><span style="color: rgb(0, 0, 128); font-family: verdana;">SPRING 2018</span><span style="color: rgb(0, 0, 128); font-family: verdana; font-size: 16px;"> SESSION</span><span style="color: rgb(0, 0, 128); font-family: verdana; font-size: 16px;"><span style="color: rgb(0, 0, 128); font-family: verdana;">                                                        </span>- 7 Classes -</span>                                             <span style="color: rgb(0, 0, 128); font-family: verdana; font-size: 16px;">Monday Afternoons</span></span></u><span style="font-family: verdana; font-size: 16px;"><br>
</span><span style="font-family: verdana; font-size: 16px;"><br>
</span><span style="color: rgb(0, 0, 128); font-family: verdana; font-size: 18px;">DATES: </span></span></span><br>
<span style="color: rgb(0, 0, 128); font-family: Verdana; font-size: 18px;">Free Trial Class- April 16</span></p>
<p class="Remove" style="text-align: center;"><span style="font-family: Arial; color: rgb(0, 0, 128);">Followed by 6 Hebrew School Classes on: </span><br>
<span style="font-size: 18px;">
<font color="#000080" face="Verdana">April 23, 30 May 7, 14, June 4 &amp; 11</font></span></p>
<p class="Remove" style="text-align: center;">
<span style="color: rgb(0, 0, 128); font-family: verdana;">Drop Off &amp; Healthy Snack: 3:20pm-3:30pm <br>
Class: 3:30pm-4:30pm </span></p>
<p class="Remove" style="text-align: center;">
<strong>
<span style="color: rgb(0, 0, 128); font-family: Verdana;"><u>Optional Pick up from local Public Schools.</u></span></strong><span style="color: rgb(0, 0, 128); font-family: Verdana;">                   <br>
*Brooklyn Arbor School, PS 132, PS 84 * <br>
Only $30 per session  <br>
Children will be given snacks and have supervised free play until Hebrew School begins.<em><br>
</em></span><em>
<span style="color: rgb(0, 0, 128);"><u>
<span style="font-family: verdana;"><br>
</span></u></span></em><span style="font-size: 13px;">
<em><span style="color: rgb(0, 0, 128);"><u>
<span style="font-family: verdana;">Email Esty to find out if Pick Up is being offered from your child's school:</span></u></span><br>
</em></span><span style="color: rgb(0, 0, 128); font-family: Comic Sans MS;">
<a href="mailto:office@Chabad11211.com"><span style="font-size: 13px;">
<em><span style="font-family: Verdana;">office@Chabad11211.com</span></em></span></a></span></p>
<p class="Remove" style="text-align: center;">
<a href="/Article.asp?AID=2326730">
<strong><span style="font-size: 13px; color: rgb(128, 0, 0);"> <span style="font-family: Arial;">TO REGISTER FOR HEBREW IMMERSION CLASS (for fluent Hebrew speaking children), "IVRIT B'IVRIT"- CLICK HERE</span></span></strong></a></p>
<p class="Remove" style="text-align: center;">
<a href="https://www.facebook.com/home.php#!/media/set/?set=a.358025040962205.76226.343801842384525&amp;type=1" style="line-height: 1.2; font-size: 10pt;">
<span style="font-family: Verdana;">CLICK HERE TO SEE PHOTOS- HEBREW SCHOOL IN ACTION! </span></a></p>
<p style="text-align: center;"> </p>
<p style="text-align: center;">
<span style="font-family: Tahoma;">
<strong><span style="color: rgb(255, 0, 0); font-size: 18px;">REGISTER HERE:</span></strong><span style="color: rgb(255, 0, 0);">                       </span></span></p>
<table border="0" width="95%" align="center" cellspacing="0" cellpadding="7">
<tbody>
<tr>
<td style="font-family: Arial; font-size: 10px;" bgcolor="#ff9900" colspan="5">
<p>
<span class="style30" style="font-family: Comic Sans MS; font-size: 14px;">Contact Information</span></p>
</td>
</tr>
<tr>
<td width="16%"><span style="font-family: Comic Sans MS;">Childs</span>                                     <span style="font-family: Comic Sans MS;">Full</span><span style="font-family: Comic Sans MS;"> Name</span><span style="color: rgb(255, 0, 0); font-family: Comic Sans MS;">*</span></td>
<td width="32%">
<input type="text" name="Childs Name" tabindex="1" required="true"></td>
<td width="3%"> </td>
<td width="17%">
<span style="font-family: Comic Sans MS;">Childs Age</span><span style="color: rgb(255, 0, 0); font-family: Comic Sans MS;">*</span></td>
<td width="32%">
<input type="text" name="Childs Age" tabindex="1" required="true"></td>
</tr>
<tr>
<td width="16%">
<p><span style="font-family: Comic Sans MS;">Parent</span>                                          <span style="font-family: Comic Sans MS;">                                                      <span class="style3">First Name</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></p>
</td>
<td width="32%">
<span style="font-family: Comic Sans MS;"><input type="text" name="Parent_first_name" tabindex="1" required="true"></span></td>
<td width="3%"> </td>
<td width="17%">
<span style="font-family: Comic Sans MS;"><span class="style3">State</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></td>
<td width="32%">
<span style="font-family: Comic Sans MS;"><input type="text" name="x_state" tabindex="5" required="true"></span></td>
</tr>
<tr>
<td>
<p><span class="style3" style="font-family: Comic Sans MS;">Parent</span>                                           <br>
<span class="style3" style="font-family: Comic Sans MS;">Last</span>                                                <span style="font-family: Comic Sans MS;">                                                      <span class="style3">Name</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></p>
</td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="Parent_last_name" tabindex="2" required="true"></span></td>
<td> </td>
<td>
<span style="font-family: Comic Sans MS;"><span class="style3">Zip</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="x_zip" tabindex="6" required="true"></span></td>
</tr>
<tr>
<td>
<span style="font-family: Comic Sans MS;"><span class="style3">Address</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="x_address" tabindex="3" required="true"></span></td>
<td> </td>
<td>
<span class="style3" style="font-family: Comic Sans MS;">Phone</span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="x_phone" tabindex="7"></span></td>
</tr>
<tr>
<td>
<span style="font-family: Comic Sans MS;"><span class="style3">City</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="x_city" tabindex="4" required="true"></span></td>
<td> </td>
<td>
<span style="font-family: Comic Sans MS;"><span class="style3">Email</span><span class="style3" style="color: rgb(255, 0, 0);">*</span></span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="x_email" tabindex="8" required="true"></span></td>
</tr>
<tr>
<td style="text-align: center;" colspan="2">
<span style="font-family: Comic Sans MS; font-size: 12px;">Does the child live with both natural parents?<span style="color: rgb(255, 0, 0);">*</span>                                          <input type="text" name="child live with both natural parents?" tabindex="1" required="true"></span></td>
<td style="text-align: center;"> </td>
<td style="text-align: center;" colspan="2">
<span style="font-family: Comic Sans MS; font-size: 12px;">Are there any adoptions in your family?<span style="color: rgb(255, 0, 0);">*  </span>                                               <input type="text" name="any adoptions in family?" tabindex="1"></span></td>
</tr>
<tr>
<td style="text-align: center;" colspan="2">
<p style="text-align: center;"><span style="font-family: Comic Sans MS; font-size: 12px;">Is the child's natural mother Jewish?<span style="color: rgb(255, 0, 0);">* </span></span>                                                <span style="font-family: Comic Sans MS; font-size: 12px;">                                                     <input type="text" name="child natural mother jewish?" tabindex="1" required="true"></span></p>
</td>
<td style="text-align: center;"> </td>
<td style="text-align: center;" colspan="2">
<span style="font-family: Comic Sans MS; font-size: 12px;">Are there any conversions in your family?<span style="color: rgb(255, 0, 0);">* </span>                                              <input type="text" name="any conversions in family?" tabindex="1"></span></td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td style="font-family: Arial; font-size: 10px;" bgcolor="#ff99cc" colspan="5"><span class="style30" style="font-family: Comic Sans MS; font-size: 14px;">Tuition: $180 for entire session</span>                                   <span class="style30" style="font-family: Comic Sans MS; font-size: 12px;"><strong>or</strong>                                          <span style="font-size: 14px;">$35 per drop in class <br>
</span><br>
<span style="font-size: 14px;"> Pick up $30 per session <br>
</span> (call or email in advance to confirm that pick up is being offered from your child's school)</span></td>
</tr>
<tr>
<td style="font-family: Arial; font-size: 10px;" bgcolor="#ffff99" colspan="5">
<span style="font-family: Comic Sans MS;"><span class="style3">$ <input type="text" size="8" name="x_amount" style="width: 68px; height: 22px;" tabindex="20"></span><span class="style3" style="font-size: 12px;"> (address above should match card billing address)</span></span></td>
</tr>
<tr>
<td>
<span class="style3" style="font-family: Comic Sans MS;"> Card Type</span></td>
<td>
<span style="font-family: Comic Sans MS;"><select name="x_card_type" style="width: 153px;" tabindex="21">
<option value="Please Select" selected>Please Select</option>
<option value="Visa">Visa</option>
<option value="American Express">American Express</option>
<option value="Mastercard">Mastercard</option>
<option value="Discover">Discover</option>
</select></span></td>
<td> </td>
<td>
<span class="style3" style="font-family: Comic Sans MS;">Exp. Date</span></td>
<td>
<span style="font-family: Comic Sans MS;"><select name="x_exp_month" tabindex="24">
<option value="Month" selected>Month</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select></span><select name="x_exp_year" tabindex="24">
<option value="Year" selected>Year</option>
<option value="2017">2017</option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
<option value="2021">2020</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
</select></td>
</tr>
<tr>
<td>
<span class="style3" style="font-family: Comic Sans MS;">Card Number</span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" name="x_card_num" tabindex="23"></span></td>
<td> </td>
<td>
<span class="style3" style="font-family: Comic Sans MS;">CVV Code</span></td>
<td>
<span style="font-family: Comic Sans MS;"><input type="text" size="15" name="x_card_code" style="width: 121px; height: 22px;" tabindex="25"></span></td>
</tr>
<tr>
<td style="text-align: center;" colspan="5">
<span style="font-family: Comic Sans MS; font-size: 11px;">You may send checks to Chabad of North Brooklyn <br>
            132 North 5th St #2c, | Brooklyn, NY 11249    or bring in on 1st day of session</span></td>
</tr>
<tr>
<td style="font-family: Arial; font-size: 10px;" bgcolor="#cc99ff" colspan="5">
<span class="style30" style="font-family: Comic Sans MS; font-size: 14px;">Comments</span></td>
</tr>
<tr>
<td colspan="5">
<span style="font-family: Comic Sans MS;"><textarea name="comments" style="width: 565px; height: 58px;" tabindex="26" cols="62"></textarea></span></td>
</tr>
<tr>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
</tbody>
</table>
<p style="text-align: center;">  <a href="/Article.asp?AID=2326730">          </a></p>
    </div>
</div>
</co:body>
			</div>
			

			<div class="break_floats"></div>
			
					<div class="clearfix">
                    	


<script>
	var recaptchaIsEnterprise = false;
		 var recaptchaV2Key = "6LcG_TcUAAAAAKAVgwgW39ujc9OCjXSoQYFIA-Su";

</script>

	<input type="hidden" class="js-recaptcha-input" name="cdo-captcha-response" value="" data-div-id="55f8459a-6901-4dcd-872a-3760cf58b634" data-processed="false" />
	<div class="js-recaptcha-wrapper" id="55f8459a-6901-4dcd-872a-3760cf58b634"></div>	

                    </div>
				
					<!------Begin Close Form------->
					<div class="ccoFormFooter">
						
							<div class="small bold center bottom_padding">
								<div class="grey f-small"></div></div>
						
						<div align="center"><input type="submit" value="Submit" name="SubmitCCO" tabindex="1000"/>
							<input type="reset" value="Reset" tabindex="1001" id="reset1" name="reset1"/></div>
						
							<p align="center" style="font-size: 8pt; color: #666666; font-family: Verdana, Helvetica; margin-bottom: 3px; margin-top: 6px;">
								<img valign="absbottom" src="https://w2.chabad.org/images/global/icons/lock.gif" width="16" height="16" alt="Secure"/>
								This page uses 128 bit SSL encryption to keep your data secure.
							</p>
						
					</div>
				
				<input type="hidden" name="FormCCOSubmited" value="true"/>
			</form>
			<!------End Close Form------->
			
	<div class="break_floats"></div>
	

<div class="content-footer">
	<!-- END CACHE -->
	
	
	
	
	
</div>
	</article>

		</div>
	</div>
</div>
						
						<div class="break_floats"></div>
						
					</div>
				</div>
				
				
				
			</div>
			
			
		</div>
		
		<aside class="page-tools-sidebar js-page-tools-sidebar hide_for_print">
<div class="page-tools js-page-tools-menu">
<div class="page-tools__section page-tools__section--share">
<a class="page-tools__tool js-share-popup page-tools__tool--facebook" data-share-url="https://www.facebook.com/dialog/share?app_id=188669250943&amp;display=popup&amp;href=https%3a%2f%2fwww.chabadofnorthbrooklyn.com%2ftemplates%2farticlecco_cdo%2faid%2f4496416%2fjewish%2fChabad-Hebrew-School-Registration-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dFB">
				<i class="fa fa-facebook"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--twitter" data-share-url="https://twitter.com/intent/tweet?text=Chabad+Hebrew+School+Registration+Form+-+Chabad+of+North+Brooklyn+&amp;url=https%3a%2f%2fwww.chabadofnorthbrooklyn.com%2ftemplates%2farticlecco_cdo%2faid%2f4496416%2fjewish%2fChabad-Hebrew-School-Registration-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dtwitter&amp;via=Chabad">
				<i class="fa fa-twitter"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--whatsapp d-lg-none js-share-whatsapp" data-share-url="whatsapp://send?text=Chabad+Hebrew+School+Registration+Form+-+Chabad+of+North+Brooklyn+ https%3a%2f%2fwww.chabadofnorthbrooklyn.com%2ftemplates%2farticlecco_cdo%2faid%2f4496416%2fjewish%2fChabad-Hebrew-School-Registration-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dwhatsapp">
				<i class="fa fa-whatsapp">
					<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 50 50" fill="#128c7e" width="1em" height="1em"><path d="M25 2C12.318 2 2 12.318 2 25c0 3.96 1.023 7.854 2.963 11.29L2.037 46.73c-.096.343-.003.711.245.966.191.197.451.304.718.304.08 0 .161-.01.24-.029l10.896-2.699C17.463 47.058 21.21 48 25 48c12.682 0 23-10.318 23-23S37.682 2 25 2zm11.57 31.116c-.492 1.362-2.852 2.605-3.986 2.772-1.018.149-2.306.213-3.72-.231-.857-.27-1.957-.628-3.366-1.229-5.923-2.526-9.791-8.415-10.087-8.804-.295-.389-2.411-3.161-2.411-6.03s1.525-4.28 2.067-4.864c.542-.584 1.181-.73 1.575-.73s.787.005 1.132.021c.363.018.85-.137 1.329 1.001.492 1.168 1.673 4.037 1.819 4.33.148.292.246.633.05 1.022s-.294.632-.59.973-.62.76-.886 1.022c-.296.291-.603.606-.259 1.19s1.529 2.493 3.285 4.039c2.255 1.986 4.158 2.602 4.748 2.894.59.292.935.243 1.279-.146.344-.39 1.476-1.703 1.869-2.286s.787-.487 1.329-.292c.542.194 3.445 1.604 4.035 1.896.59.292.984.438 1.132.681.148.242.148 1.41-.344 2.771z"/></svg>
				</i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--pinterest d-none d-lg-block" data-share-url="http://pinterest.com/pin/create/button/?url=https%3a%2f%2fwww.chabadofnorthbrooklyn.com%2ftemplates%2farticlecco_cdo%2faid%2f4496416%2fjewish%2fChabad-Hebrew-School-Registration-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dpinterest&amp;description=Chabad+Hebrew+School+Registration+Form+-+Chabad+of+North+Brooklyn+">
				<i class="fa fa-pinterest"></i>
			</a>
<a class="page-tools__tool" onclick="showEmailLayer(this);">
<i class="fa fa-envelope"></i>
</a>
</div>
<div class="page-tools__section page-tools__section--other js-page-tool-other">
<div class="page-tools__tool popover-parent d-lg-block">
<div class="popover popover--right align_left nowrap">
<div class="popover__content">
<label class="bold bottom_margin block">
Print Options:
</label>
<form class="vcenter" name="print-form" onsubmit="coPrint(event, 2923026);return false;">
<div>
<label><input type="checkbox" name="print-green"><span title="Save paper and ink">Print without images <i class="fa fa-leaf text-green"></i></span></label>
</div>
<br/>
<div class="center">
<button class="co-button page-tools__print-button">Print</button>
</div>
</form>
</div>
</div>
<i class="fa fa-print"></i>
</div>
</div>
</div>
<div class="js-fab-wrapper fab-wrapper">
<div class="fab">
<i class="fab-icon"></i>
</div>
</div>
</aside>
<!-- END CACHE -->
	</div>

				<div class="break_floats"></div>
			</div>
		</div>
	</div>
	<div id="footer">
		
	

		<div class="wrapper body_container">
			
			<div class="g960 footer_family_text bottom_padding">
				
		<div class="footer_container footer_text copyright_text">
			<div class="bottom_padding clear_float">
				<img class="footer_hr" src="https://w2.chabad.org/images/global/spacer.gif" vspace="12" width="100%" height="1" /><br />
				
				<div class="footer_inner_container clearfix">
					

					



	<div class="footer3">
		<span class="footer-title" >Chabad of North Brooklyn </span>
		<div class="footer-address">
			<span class="footer-street">132 North 5th Street  #2C</span>
			<span class="footer-city-state">Brooklyn, NY 11249-3259</span>
		</div>
			<span>718-388-0748</span>
	</div>
	<img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="6" border="0" /><br />



Powered by <a href="https://www.chabad.org/" target="_new" class="">Chabad.org</a> &copy; 1993-2026 <a href="/4026210" target="_blank" class="privacy-link">Privacy Policy</a>




					
				</div>
			</div>
		</div>
	
			</div>
			
		</div>
	</div>

	
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery-latest.min.js?g=20&v=0293E3EC"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/co/dist/CoLib.js?g=20&v=F809B22F"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/WebComponents/bundles/magen-cdo-global.js?g=20&v=95D39855"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/primarynavigation.js?g=20&v=76ABCD73"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/modules/pagetools.js?g=20&v=930B07AB"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/BetaFeedback.js?g=20&v=D421ABC8"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/multimedia/infolayer.js?g=20&v=ED1B8531"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/commentsloader.js?g=20&v=AD6AAB79"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/subscribeprompt.js?g=20&v=86D84DC2"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/FormDecoder.js?g=20&v=83AF6F1A"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/deprecated.js?v=D506A83E&g=20"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/OverrideJSDocumentWrite.js?g=20&v=9A0227AA"></script><script>$j = $j.fn ? $j : jQuery;$j(()=>{$q.forEach(f=>{try{f.call(window);}catch(ex){console.error(ex);}});})</script>
	

<script  language="javascript" type="text/javascript"> Co.Settings      = {CacheClassName:'js-cache-default',MosadName:'Chabad of North Brooklyn '}; Co.ArticleId     = '4496416';Co.SectionId     = 2901920;Co.PartnerSiteId = 0;Co.SiteId        = 4177;Co.IsMobilePage  = false;Co.IsResponsive  = false;Co.DbDomain      = 'ChabadofNorthBrooklyn.com';Co.LanguageCode  = '';Co.LoginStatus   = 'None';</script>

    

</body>
</html>