Bet Limmud Registration Form

Parent 1 First Name

Parent 1 Last Name

* Preferred Phone Parent 1

Email Parent 1

First Name Parent 2

Last Name Parent 2

Preferred Phone Parent 2

Email Parent 2

Emergency Contact #1 (Name, Relation and Phone Number)

Emergency Contact #2 (Name, Relation and Phone Number)

* First Name Student 1

* Last Name Student 1

Birthdate Student 1

* Current Grade Student 1

Pronouns Student 1

Preferred Name or Nickname Student 1 (If different)

Hebrew Name Student 1 (English Alphabet) and include parents' Hebrew names if known

Hebrew Name Student 1 (Hebrew Letters if known)

Name of School-Student 1

* Student 2 First Name

Last Name Student 2

Birthdate Student 2

* Current Grade Student 2

Pronouns Student 2

Preferred Name or Nickname Student 2 (If different)

Hebrew Name Student 2 (English Alphabet) (please include any parents' Hebrew names if known)

Hebrew Name Student 2 (Hebrew Letters if known)

Name of School-Student 2

* Student 1: Please share a little about your child's general temperament and learning style for the sake of trying to create a positive learning environment for them.

* Student 1: Tell us some of your child's likes and dislikes, hobbies, interests and/or extra-curricular activities.

Student 2: Please share a little about your child's general temperament and learning style for the sake of trying to create a positive learning environment for them.

* Student 2: Tell us some of your child's likes and dislikes, hobbies, interests and/or extra-curricular activities.

Who does/do student(s) live with?

Number of Children for Registration

* Tuition

Our tuition is based on a sliding scale annual fee of $360-900 per student. To put this in context, this equates to $10-25 per learning session. Please choose an amount that works for your family. No one will be turned away for lack of funds. For need-based scholarship information, please contact Lisa (lisa@cbsaz.org or 520.233.7813.)

On the next screen you will be able to set up monthly payments. Simply click on the dropdown next to "Pay this Amount" and change it from "Once Now" to however many payments you'd like to set up. It is recommended to pay it in 12 payments or less.

Sat, July 27 2024
21 Tammuz 5784

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Sat, July 27 2024 21 Tammuz 5784