Traveling Hebrew School Home Welcome to the Hebrew School that travels to you! Application Form Application FormName* First Last Suffix Birth Date* MM slash DD slash YYYY Current School* Grade in 2020-2021*GradeKindergartenFirstSecondThirdFourthFifthSixthSeventhHebrew Reading Proficiency* None Somewhat Well Previous Jewish Education* YES NO If Yes, Where?* Parent informationFather's Name* First Last Father's Cel. Number*Father's Email Address* Mother's Name* First Last Mother's Cel. Number*Mother's Email Address* Address* Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency InformationEmergency Contact* Emergency Contact Phone*My Child/ren is a ... (check one of the options in the dropdown box)*CohenLeviIsraelNot SureAre the natural father and mother of the child Jewish?* YES NO If no, please explain.* Have there been any conversions or adoptions in the family?* YES NO If yes, please explain*