Hebrew School Application 2021-2022 - Form

E-mail

STUDENT INFORMATION

* Child 1 First Name

* Child 1 Last Name

Child 1 Hebrew Name

* Child 1 Birthday

* Child 1 Gender

Child 1 Cell Number (if applicable)

* Child 1 School

* Child 1 School Address/Cross Streets

* Child 1 Grade

Previous Jewish Education Experience

IF APPLICABLE, PLEASE DESCRIBE YOUR CHILD’S PREVIOUS JEWISH-EDUCATION EXPERIENCES (E.G. CAMP, TUTORING, DAY SCHOOL, AFTERNOON RELIGIOUS SCHOOL, ETC.).

Learning Methods

HOW DOES YOUR CHILD LEARN BEST? WHAT SUBJECT(S) DOES S/HE LIKE MOST/LEAST? WHAT ARE HER/HIS AREAS OF STRENGTH/WEAKNESS?

* Permission to Walk Home Alone

Please Select OneYesNoDOES THE STUDENT HAVE PERMISSION TO WALK HOME FROM ACHS ALONE?

* Permission To Walk Home With Somebody Else

Please Select OneYesNoPERMISSION TO WALK HOME FROM ACHS WITH SIBLING OR FRIEND?

Sibling and Friend Names

WHICH SIBLINGS OR FRIENDS CAN THE CHILD WALK HOME WITH

* Allergies

Please Select OneYesNoDOES YOUR CHILD HAVE ANY FOOD ALLERGIES?

Allergy Foods

PLEASE LIST YOUR CHILD'S FOOD ALLERGIES.

Medications

PLEASE LIST ANY MEDICATIONS YOUR CHILD CURRENTLY TAKES

Special Services

PLEASE LIST ANY SPECIAL SERVICES YOUR CHILD RECEIVES, E.G. SPEECH OR OCCUPATIONAL THERAPY

IEP

YesNoDOES YOUR CHILD HAVE AN IEP?

Recent Changes Affecting Learning

PLEASE TELL US ABOUT ANY RECENT CHANGES IN SCHOOL OR AT HOME THAT MIGHT AFFECT YOUR CHILD’S/CHILDREN’S LEARNING.

Hebrew School Goals

WHAT ARE YOUR GOALS FOR YOUR CHILD’S HEBREW SCHOOL EXPERIENCE THIS YEAR?

Child 2 First Name

Child 2 Last Name

Child 2 Hebrew Name

Child 2 Birthday

Child 2 Gender

Child 2 Cell Phone (if applicable)

Child 2 School

Child 2 School Address/Cross-Streets

Child 2 Grade

Previous Jewish Education Experience

IF APPLICABLE, PLEASE DESCRIBE YOUR CHILD’S PREVIOUS JEWISH-EDUCATION EXPERIENCES (E.G. CAMP, TUTORING, DAY SCHOOL, AFTERNOON RELIGIOUS SCHOOL, ETC.).

Learning Methods

HOW DOES YOUR CHILD LEARN BEST? WHAT SUBJECT(S) DOES S/HE LIKE MOST/LEAST? WHAT ARE HER/HIS AREAS OF STRENGTH/WEAKNESS?

Permission to Walk Home Alone

YesNoDOES THE STUDENT HAVE PERMISSION TO WALK HOME FROM ACHS ALONE?

Permission To Walk Home With Somebody Else

YesNoPERMISSION TO WALK HOME FROM ACHS WITH SIBLING OR FRIEND?

Sibling and Friend Names

WHICH SIBLINGS OR FRIENDS CAN THE CHILD WALK HOME WITH

Allergies

YesNoDOES YOUR CHILD HAVE ANY FOOD ALLERGIES?

Food Allergies

PLEASE LIST YOUR CHILD'S FOOD ALLERGIES.

Medications

PLEASE LIST ANY MEDICATIONS YOUR CHILD CURRENTLY TAKES

Special Services

PLEASE LIST ANY SPECIAL SERVICES YOUR CHILD RECEIVES, E.G. SPEECH OR OCCUPATIONAL THERAPY

IEP

YesNoDOES YOUR CHILD HAVE AN IEP?

Recent Changes Affecting Learning

PLEASE TELL US ABOUT ANY RECENT CHANGES IN SCHOOL OR AT HOME THAT MIGHT AFFECT YOUR CHILD’S/CHILDREN’S LEARNING.

Hebrew School Goals

WHAT ARE YOUR GOALS FOR YOUR CHILD’S HEBREW SCHOOL EXPERIENCE THIS YEAR?

CONNECTION TO ANSCHE CHESED HEBREW SCHOOL

Hearing About ACHS

HOW DID YOU HEAR ABOUT ACHS?

Enhancing ACHS Family Experience

WHAT CAN WE DO TO MAKE YOUR FAMILY’S EXPERIENCE AT ACHS AS MEANINGFUL AS POSSIBLE?

PARENT INFORMATION

* Parent 1 First Name

* Parent 1 Last Name

* Parent 1 Email

* Parent 1 Mobile

Parent 1 Work Phone

Parent 1 Occupation

Parent 1 Religious Background

* Member of Ansche Chesed

Please Select OneYesNo

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Mobile

Parent 2 Work Phone

Parent 2 Occupation

Parent 2 Religious Background

Member of Ansche Chesed

YesNo

* Primary Address

* City

* State

* Zip Code

As a Conservative synagogue, Ansche Chesed adheres to a matrilineal definition of Jewish identity. If you or your child/ren were not born to a Jewish mother, please consult with Rabbi Yael or Rabbi Kalmanofsky.

Divorced or Separated Parents

IF STUDENT’S/STUDENTS’ PARENTS ARE DIVORCED OR SEPARATED, PLEASE TELL US THE NAME OF THE CUSTODIAL PARENT.

Remarried Parent Spouse

IF EITHER PARENT HAS REMARRIED, PLEASE TELL US THE NAME(S) OF THE CURRENT SPOUSE(S):

COMMUNICATION WITH US

Email is ACHS’s primary means of communication. If you prefer that we use another method to reach you, please tell us what that is and initial below.

Communication

PREFERRED MEANS OF COMMUNICATION

Initials

YOUR INITIALS

Cell Phone Initials

We will be using a cell phone texting service to notify parents in case of emergency. Please initial here as permission to contact you by cell phone:

PICK-UP AND EMERGENCY INFORMATION

THE FOLLOWING PEOPLE ARE AUTHORIZED TO PICK UP MY CHILD/CHILDREN.
NOTE: ACHS must be notified if anyone not on this list has permission to pick up your child/children.

Full Name

Relationship To Student

Cell Phone

Work Phone

Home Phone

EMERGENCY CONTACTS*

In an emergency, parents are contacted before anyone else. Please let us know whom we may contact in an emergency if we are unable to reach you.

* Full Name

* Relationship To Student

* Phone Number

Physician Name

Physician Phone Number

Insurance

Policy Number

Policy Holder Name

PERMISSIONS AND VOLUNTEERS

Emergency Room Care

Emergency Room CareI hereby state my permission for the staff of Ansche Chesed to take my child/children to a hospital emergency room or urgent care facility in the event that I or my representatives above cannot be reached. All necessary treatment may be given at that time.

Field Trip Permission

Field Trip PermissionI hereby permit my child/children to participate in any program (including tutoring) and to go on any class field trip during the year. I will be notified of any class trip before it occurs.

Media Release

Media ReleaseI hereby permit Ansche Chesed and the Ansche Chesed Hebrew School to capture and use my child/children’s likeness(es) in photographs and videos, and in audio recordings for purposes that help promote ACHS and Ansche Chesed.

* Parent Volunteer Opportunities

Serve on the ACHS Parent CommitteeServe as a Class ParentAssist in planning the ACHS Purim FundraiserChaperone on class field tripsMake runs to Costco or other suburban shopping centers for food, art supplies, etc. (as needed)

HEBREW SCHOOL TUITION POLICIES

Membership: The parents of all students entering Kitah Gimel (Third Grade) and above must be members in good standing of Ansche Chesed. For information about membership, please contact Josh Hanft, Executive Director, at 212-865-0600 ext. 209 or JHanft@anschechesed.org.

Outstanding Balance: Outstanding balances on previous years’ tuition must be paid in full or otherwise addressed before students may be enrolled for the current year. To discuss outstanding balances, please contact Josh Hanft, Executive Director, at 212-865-0600 ext. 209 or JHanft@anschechesed.org.

Non-Refundable Deposit: A non-refundable deposit of $200 per student is required to hold your child/children’s space(s).

Early Bird Special: Parents whose applications are received before August 15th, 2021 will receive an Early Bird Discount of $75 per student.

Post-Dated Checks: If tuition is not paid in full before the start of the school year, parents must submit four post-dated checks made out in equal monthly installments and be dated October 1, November 1, December 1 and January 1.

Bounced Checks: Bounced checks will be subject to a $25 per-check penalty.

Tuition Due Date: Tuition is due in full by December 15th, 2021.

Financial Need and Scholarships: ACHS does not turn away students because of financial need. To have a confidential discussion about scholarships, contact Josh Hanft, Executive Director, at 212-865-0600 ext.209 or at JHanft@anschechesed.org.

Learning Materials: Tuition includes all books and other regular class materials.

Academic Calendar: ACHS will begin this year on Wednesday, October 6th, 2021 and will conclude on Thursday, May 19th, 2022.

We encourage registered ACHS families to join AC Holiday Family Services and Programs for FREE in September!

This year, ACHS will offer 2 Hebrew language learning options for 3rd through 6th grade students:

Option 1: Tuesday In-Person Hebrew Pods at AC, Tuesdays 4:00 - 4:45pm

ACHS students will meet in-person, in small leveled Hebrew groups, with ACHS teachers. Hebrew groups will progress at their own appropriate pace, and will be geared to the learning needs of each learner.

Option 2: Hebrew Homepage (HHP) at Home, Privately scheduled, 30 minutes / week

ACHS is partnering with Jewish Journeys, through The Marlene Meyerson JCC Manhattan, in order to offer Hebrew Homepage (HHP). HHP is a highly successful online Hebrew learning platform in which participants study with a tutor one-on-one using a webinar platform for weekly 30-minute sessions. This program will allow students to study ACHS approved Hebrew curriculum at their own pace, at a time that works best for their schedule, from the convenience of their own homes. HHP offers curriculum options for beginning readers, for gaining reading fluency for prayerbook Hebrew, and Modern Hebrew for beginners.

ACHS yearly tuition is the same this year for both Hebrew options, and registration is through the ACHS office.
Hebrew Homepage students will sign up for their tutoring slot individually before the school year begins.

Hebrew Language Options for 3rd - 6th Grades: Would you like your child to participate in Tuesday In-Person Hebrew Pods OR Hebrew Homepage?

Tuesday In-Person Hebrew Pods (child 1)Hebrew Homepage (child 1)Tuesday In-Person Hebrew Pods (child 2)Hebrew Homepage (child 2)Tuesday In-Person Hebrew Pods (child 3)Hebrew Homepage (child 3)

Questions? Please contact the ACHS office to discuss the best choice for your child: rabbiyael@anschechesed.org or 212-865-0600 x208.

If application is received before the early bird deadline of August 15, 2021, type in the discount codes of EarlyBird1 for one child discount of $75 and EarlyBird2 for a two children discount of $150 on the next payment page.

If the discount doesn't apply after typing in the code, please click an empty part of the screen outside of the text box, which should fix the issue.

Additional Hebrew School Donation

If there is any additional donation you would like towards the Ansche Chesed Hebrew School, enter that number here.

Tuition plus additional Hebrew School Donation