Online Registration Form

Online Registration Form

   Online Registration Form ( Click here to register via fax or mail)  

To the National Committee for the Furtherance of Jewish Education
and the Principal of PS

Please enroll my child in the Released Time Program 

First Name
Last Name
Mother's Jewish Name
Address
City/State/Zip           
Phone Number
Cell Number
Email address
Date of Birth      Year
Gender  Boy Girl
Grade
Room Number

PS

    
Comment (optional)

As the Parent or legal guardian of the above child, I enroll my above child in the Released Time Program, throughout the school year of 2017/18.

Name     Initials     Date   

- OPTIONAL - 

To add more children in the same household, please use the fields below:

Child 2:
First Name

 
Last Name


Date of birth
        Year

Gender  Boy Girl  
PS  Grade 
Room Number 

Child 3:
First Name

 
Last Name



Date of birth
        Year
Gender Boy Girl    

PS
 

Grade

Room Number

 

 

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