Registration - CHAI CENTER-CHABAD

Address

Phone Number
E-mail
Students
First year in Hebrew School ?

yesno
Student 1 Birth Date

Month Day Year
Student 2 Birth Date

Month Day Year
Full Payment or Monthly

$850$85
Monthly Payments - First payment at registration $85 and 9 monthly payment starting Sep 1st -May 1st
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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Hebrew School 2026-2027 -Registration Form