4501 Cartwright Rd. #770 Missouri City, TX 77459 (832)758-0685


Registration Application


Last name:_______________________________

First name:


                     English                           Hebrew                     Age              Date of birth            Grade entering


Child 1


Child 2


Child 3



Mailing address


____________________________         __________          ______________

Address                                                                               City                                   Postal code


Phone No.______________________

E-mail address__________________________


Non registered children


Name_________________________ Age________               Name_________________________ Age___


Parent information


Father’s name: ____________      _______________     Business or Profession_______________________

                         English                  Hebrew

Business name:__________________________Business number__________________________________

Business address:________________________________________________________________________


Mother’s name:____________       _____________        Business or Profession______________________

                         English                   Hebrew

Business name:__________________________ Business number_________________________________

Business address:________________________________________________________________________


Mother’s maiden name:_________________________


Synagogue with which family is affiliated:_________________________


Registration Application    (page 2)



Does your child/ren read basic Hebrew yet?

                                                                                      (Please circle one)

Child 1________________________Age____  No    Poor      Fair       Good


Child 2________________________Age____ No     Poor      Fair       Good


Child 3________________________ Age____ No    Poor      Fair       Good


Does your child have any learning difficulties with general studies?_______




Is there any special medical or other information regarding your child/ren which our school should be aware of?_______________________________





Please list two numbers to be used in case of emergencies


Name_____________________ Relationship____________ Tel__________


Name_____________________ Relationship____________ Tel__________


I hereby permit my child/ren to participate in all school activities, join in class and school trips on and beyond school properties.  In case of an emergency, I hereby authorize the school to have my child/ren taken care of by a physician in any way the situation may call for.


Signature of Parent or Guardian _____________________ Date _________


Annual tuition-$550 per child.

A link to the past…
a bridge to the future.