Afternoon School New Student Enrollment

Student Information

Name*

First Last

Date of Birth*

Pronouns*

he/him
she/her
they/them

Hebrew Name

Current School

Current Grade

Bar/Bat Mitzvah Date

(where applicable)

Synagogue Affiliation

Parent/Guardian Information

Parent/Guardian #1

Name*

First Last

Pronouns

He/him
She/her
They/them

Relationship to Student*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone

Email*

Parent/Guardian #2

Name

First Last

Pronouns

He/him
She/her
They/them

Relationship to Student

Address

Same as Parent/Guardian #1

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone

Email

Student Information

Please describe your child's strengths, challenges, and interests:

Please let us know any additional information that would help us provide the best possible educational experience for your student (such as an IEP).

Hidden

Would you like to enroll a second student?

Yes
No

Student 2

Name

First Last

Date of Birth

Pronouns

he/him
she/her
they/them

Hebrew Name

Current School

Current Grade

Bar/Bat Mitzvah Date

(where applicable)

Please describe your child's strengths, challenges, and interests:

Please let us know any additional information that would help us provide the best possible educational experience for your student (such as an IEP).

Family Information

Additional Siblings:

Sibling Name	Age	Current School

Please describe your family's - and child(ren)'s - Jewish involvement and experiences:

Photo Publication Policy

We would like to use photos of our students in newsletters and on the webpage. Students featured in the pictures will not be identified by name without prior permission from the parent. Please check below that you are in agreement with this policy. If you are not in full agreement, please list any restrictions.

I authorize the use of my student's photograph without name identification in school publications and promotional materials without compensation or further authorization.

Photo Publication Policy - Comments/Restrictions:

Tuition Assistance

Limited tuition assistance is available for families who demonstrate a need.

Please check here if you are interested in learning about our tuition assistance program.

Parent/Guardian Signature*

Payment

Afternoon School Tuition*

Price:

Afternoon School Tuition Student 2*

Price:

Payment Method*

Pay by credit card (processed by PayPal; no PayPal account required)
Pay by check
Pay by payment plan

Please note that upon submission, you will be taken to PayPal's website in order to enter your credit card information.

Please make your check payable to "Talmud Torah of St. Paul" and mail it to the school office at:

Talmud Torah of St. Paul
Marjorie Smith Hofman Educational Building
768 Hamline Avenue South
St. Paul, MN 55116

A staff member from our office will contact you as soon as possible to set up a payment plan.

Would you like to add an amount to cover the credit card convenience fee?

Yes - let me add a 2.5% contribution

Additional contribution to cover the credit card convenience fee

Price: $0.00

Total

$0.00

Billing Address*

Same as Parent/Guardian #1

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Phone*

Billing Email*

CAPTCHA