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LEV Academy Enrollment 2023-24

Note: this form is formatted for a wide screen and may not display properly on a mobile device.


Instructions for LEV Academy Enrollment Form:

Fill out the Enrollment section for up to two children. If you are enrolling 3 or more students, you will have to complete and submit this form twice.

If you are having difficulty with the form, please contact Inbar Robbins, Education Director at
732.334-8774 or
pjchebrewschool@gmail.com.

FAMILY INFORMATION

  
  
  


ALLERGY INFORMATION

Information for Student (1)

Information for Student (2)

All EpiPens at LEV Academy must be labeled with the child's full name.

All EpiPens at LEV Academy must be labeled with the child's full name.


SCHOOL INFORMATION

If yes, we will contact you to discuss the appropriate accommodations for your child.
 

If yes, we will contact you to discuss the appropriate accommodations for your child.


FAMILY PUBLICITY PERMISSION 

At times during the school year, photos and/or videos of your child may be taken participationg in programs and events or showcasing something they are currently learning.  LEV Academy may chose to use your child's photo/video in our marketing and advertising campaigns in print, on our website or on social media.  Please let us know if you give us permission to do so.

By clicking yes - you are agreeing that Student's photograph, name, art, written work, voice, or verbal statements may appear in LEV Academy/Perrineville Jewish Center publicity, publications, and/or marketing literature (inclusive of social media and website).


FAMILY MEDICAL EMERGENCY INFORMATION



TUITION AND FEES

Choose one below for each student enrolling. If you require alternate payment arrangements, please contact our Treasurer, Lori Feibus at
pjcnews@gmail.com.

If you have made a financial arrangement with PJC/LEV Academy that is different from the options above, please click here to register without being billed through this form. If you would like to speak to someone about a special financial arrangement, please contact the Lori Feibus at  pjcnews@gmail.com before submitting this form.

 

Wed, October 4 2023 19 Tishrei 5784