Adat Shalom Re-enrollment 2021-2022

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Dear families,

Please complete this form to confirm your child(ren)'s re-enrollment for the 2021-2022 school year. If you would like to register an additional child who has not yet attended, please use the full registration form, found at adatshalom.org/registration

Upon completion of this form you will be sent a link to pay the deposit: https://adatshalom.org/schoolpayment/

All deposits must be paid before children can be registered for school.

You may also download our scholarship form here: adatshalom.org/registration

Scholarship forms may be emailed to Carma Gargaro at cgargaro@adatshalom.org or faxed to 248-851-3190

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E-poštni naslov *

Names of child(ren) currently enrolled *

Tuition and Payment Information

Tuition:

Pre-K (3 & 4 year olds), K, and 1st grade — Members: No cost; Non-members: $825

Grades 2-7 — Members: $1100; Non-members: $1850

Discounts Available:

Early Bird Registration by July 16, 2021 - $50 per child
Pay in Full by October 15, 2021 - $50 per child
Multiple sibling discount -- 10% for each additional tuition-paying sibling.

Limited scholarship is available. Open the Education Scholarship Form for 2020-2021 by clicking here:

http://www.adatshalom.org/registration

The scholarship form should be returned to cgargaro@adatshalom.org (Carma Gargaro), or faxed to 248-851-3190

A deposit is required for each student in order to be placed in a class. If you register on or before July 16, 2021 you will qualify for the early bird discount. This $50.00 discount is taken off of the tuition for each child registered.

Deposits can be paid online at http://adatshalom.org/schoolpayment

I hereby confirm that my above named child(ren) may be re-enrolled for the 2021-2022 school year. I understand that I must pay a deposit upon completing this form for grades 2 to 7 (members) and grades Pre-K to 7 (non-members).Please type your name below as an e-signature *

How are you planning to pay your tuition this year? *

Pay in full by October 15, 2021 (receive a discount)

Pay in three installments (October 15, 2021 - January 14, 2022 - April 8, 2022)

Pay in nine monthly installments (October 1 to June 1, unless otherwise arranged)

There is no tuition due for my child(ren)

What is your preferred payment method? *

Bill me based on the payment plan I selected

Use my credit card. I understand that I will be contacted for my credit card information.

There is no tuition due for my child(ren)

For the above named child(ren), all information on file is still accurate (school, medical, emergency contacts, educational needs). *

Yes

All of my children are fully immunized. *

Yes

If you answered no to either of the previous questions, please indicate changes/explain below.

Would you be interested in an enrichment Hebrew program by Zoom for your child(ren)?

Modern Hebrew Mondays

Hebrew Reading

Both

Neither

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Do you have any questions or comments that we can assist you with?

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