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Bet Limmud Registration Form
Please verify reCaptcha before submitting the 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.
Fri, May 9 2025
11 Iyyar 5785
Fri, May 9 2025 11 Iyyar 5785