Midrasha New Student Enrollment

This registration form is for NEW students enrolling in Midrasha. If you would like to re-enroll a returning student, please click here.

Please enable JavaScript in your browser to complete this form.

NEW STUDENT INFORMATION

Student Name
Date of Birth
Student Pronouns

PARENT/GUARDIAN INFORMATION

Parent/Guardian #1
Parent/Guardian #1 Pronouns
Parent/Guardian #1 Address
Parent/Guardian #2
Parent/Guardian #2 Pronouns
Parent/Guardian #2 Address

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).

FAMILY INFORMATION

Please list any additional children in the home. Their names, ages and current school.
Please describe your family's - and child(ren)'s - Jewish involvement and experiences:

PHOTO PUBLICATION POLICY

Photography Release
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.

TUITION ASSISTANCE

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

AFTERNOON SCHOOL PAYMENT

Payment Options
Payment Type
$ 0.00
Billing Email
Billing Address