Step 1: ONLINE REGISTRATION
United Jewish School

Complete Registration Form.  You will be billed by email through Jewish Federation of GR

* Required fields
Name *
E-mail Address *
Has your street address changed since last year?
Student 1 Name
Student 1 Birthdate and time of birth (to determine Jewish date we need exact time and am or pm)
Religious school grade (Should be the same grade as public school)
Student 1 Hebrew Name (ex: Johana bat Shlomo v'Sara)
Student 2 Name
Student 2 Birthdate and time of birth (to determine Jewish date we need exact time and am or pm)
Religious school grade (Should be the same grade as public school)
Student 2 Hebrew Name (ex: Johana bat Shlomo v'Sara)
Student 3 Name
Student 3 Birthdate and time of birth (to determine Jewish date we need exact time and am or pm)
Religious school grade (Should be the same grade as public school)
Student 3 Hebrew Name (ex: Johana bat Shlomo v'Sara)
Student 4 Name
Student 4 Birthdate and time of birth (to determine Jewish date we need exact time and am or pm)
Religious school grade (Should be the same grade as public school)
Student 4 Hebrew Name (ex: Johana bat Shlomo v'Sara)
Class Selection choose all that apply *
Congregational Affiliation *
Student Address, City, State, Zip *
Parent 1 Name and phone
Parent 1 Email
Parent 2 Name and phone
Parent 2 Email
Does Student Live With Both Parents
If student not living with parents, with whom does the student live?
I, (parent name)
Name and Relationship of Emergency Contact
Home/Cell Phone of emergency contact
List allergies/special needs and medications (specify student) *
Are all immunizations up-to-date for your children? *
Do you have a waiver from the county health department for immunizations for your children? This will be required if immunizations are not up-to-date. *
Does your child receive any special education services at school? Please describe. Please specify child.
Does your child have an IEP (Individual Education Plan) at his/her school? Please describe how best to implement the plan in our program. Please specify child.
Would you allow the school to provide us with a copy of the IEP?
Contact person and phone number for school.
Please describe any accommodations your child requires to be successful at school. Please specify child.
Electronic Signature *


Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.



You will be eBilled by the Jewish Federation of GR.  See you at UJS.