2026-27 JEWL Registration Form

Account ID

Learner Contact Id

Parent Contact ID

Learner Information

Please note that JEWL registration is only available to current members of Temple Israel. For any questions on membership, please contact Roberta Bonoff, Executive Director, at 612-374-0348. This form must be completed by a parent or legal guardian of the learner being registered.

We never want finances to be an obstacle to Jewish education at Temple Israel. If a scholarship is desired, please contact: JEWL@templeisrael.com before continuing.

Learner first name:

Learner last name:

Learner date of birth:

Learner preferred name:

If different from above

Learner's name pronunciation (if applicable):

Does the learner have a Hebrew name?

Hebrew name:

We will be in touch with you about getting your learner a Hebrew name.

Learner gender:

Learner gender specifics:

Learner pronouns:

This helps us understand the best way to address your child. For example, choose “She/her/hers” if your child would like us to say “She’s celebrating her birthday today!” on your child’s birthday. You can also specify if the correct option isn't listed.

Learner pronoun specifics:

School grade your learner is entering in Fall 2026:

Name of learner's weekday school:

Course & Tuition Information

Is this your learner's first year in the JEWL program?

Welcome!

We welcome you and your student to JEWL, we are very glad to have you! Our Consecration Service, on Sunday, October 4, at 11:00 a.m., welcomes and blesses new learners as they begin their Judaic Education. More information on this special will be emailed to you closer to the start of school.

Select grade program:

Was your learner enrolled in the 6th grade JEWL program last year?

9th & 10th Grade JEWL Session Information

Grades 9 and 10 meet exclusively on Sundays at Temple Israel throughout the school year.

Is your student interested in becoming a Madrichim?

YesNo

8/27/2025 Update: Important Note For 2nd Grade Learners

Second grade JEWL first session (8:45 - 10:45 a.m.) is now closed. Please select second session (10:00 a.m. - 12:00 p.m.) only. All further second grade learner applications will be placed in the second session. We apologize for any inconvenience.

I acknowledge that second grade first session enrollment is no longer available.

Please indicate a preference for your learner’s Sunday session time:

Note: For optimal student learning and engagement, we will be monitoring class size.

Choose your weekday session:

Friend Placement Request

We welcome you to request one friend to be in your child’s class. This will be honored if the friend also requests your child to be in their class.

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Parent/Guardian Information

Learner has:

Has this status or your family structure changed in the last year?

YesNo

Please tell us more about your family, to best support your learner's needs:

Parent/Guardian 1 Information

P/G 1 first name:

P/G 1 last name:

P/G 1 mobile number:

P/G 1 email address:

Street address:

City:

State:

ZIP:

P/G 1 Id

Parent/Guardian 2 Information

P/G 2 first name:

P/G 2 last name:

P/G 2 mobile number:

P/G 2 email address:

Street address:

City:

State:

ZIP:

P/G 2 Id

Information About Parent Groups and More

I am interested in receiving info about Mom and/or Dad groups offered for parents of JEWL learners:

Emergency Contacts

Please list name, relationship, and phone number for at least two (preferably three) people we may contact in the event of an emergency if parent(s)/guardian(s) cannot be reached (please do not enter the same information as parent/guardian(s) above unless you have no other contacts).

Name:

Relationship:

Phone:

Name:

Relationship:

Phone:

Name:

Relationship:

Phone:

Grandparent Information

Temple values opportunities for multi-generational education and periodically invites grandparents to special programs, volunteer opportunities, or to support our programs. We invite you to share information about your learner’s grandparent(s) below. To add additional grandparents, click the "Add another response" link at the bottom right.

Grandparent first name:

Grandparent last name:

Grandparent email:

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Medical Information & My Learner's Needs

Medical Information

Does your child have any allergies?

Allergy details:

Does your learner have a prescription for an epinephrine auto injector?

Learner will bring epinephrine auto injector/allergy medications to school.

We will reach out over the summer to obtain your child's Allergy Action Plan, which will require a signature from a health care provider.

Please list below any health concerns or diagnoses such as asthma, anxiety, depression, diabetes, epilepsy, eye or ear problems, heart disease, or any diagnosis or condition of which JEWL should be aware.

Please list below any learning concerns or diagnoses such as: ADD, ADHD, autism spectrum disorder, cognitive developmental delay, a learning disability, obsessive-compulsive disorder, a speech or language disorder, or any diagnosis or condition of which JEWL should be aware.

Does your learner have an Individual Education Plan (IEP), 504 Plan, OHD (Other Health Disability) or other education plan from their school district?

Education plan details:

Would you like a member of our Care Team to reach out to you to discuss your child's education plan?

Does your learner require the use of a mobility device to get around?

Does your learner receive support services (for example: occupational therapy (OT), speech therapy, physical therapy (PT), or paraprofessional support services) at home or in the community?

Support services details:

Does your learner have any difficulty being understood or difficulty with speech patterns?

If Yes, please explain:

Is medication needed to be administered during JEWL class hours?

Medication details:

My Learner's Needs

We look forward to partnering with you and your student for a successful year in JEWL. Please share with us any info about your student that you think will be helpful for them to have a successful year:

Explain your learner’s Jewish culture exposure. How do they feel about Judaism?

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Authorization

PARENTAL/GUARDIAN CONSENT – Please indicate that you have read and agree to each section by typing your initials in the boxes and signing at the bottom.

I give my learner permission to attend the indicated Temple Israel education program(s). I hereby release and hold harmless Temple Israel, and their respective employees, of and from any and all present and future claims of any kind or nature arising from my learner's attendance at Temple Israel’s education programs and participation in any of its programs and activities, and/or use of its facilities.

I acknowledge that, by enrolling in JEWL – Temple Israel, I and/or my child(ren) may be exposed to risks that may result in severe illness. I understand that JEWL and Temple Israel cannot control these risks and I voluntarily assume all risk to my child(ren)’s health and my health that may result due to enrollment in JEWL – Temple Israel. On my behalf and on behalf of my child(ren), I hereby release and hold harmless Temple Israel, its Board of Directors, and employees of and from any and all present and future claims of any kind or nature arising from my child’s attendance at JEWL – Temple Israel, participation in any of its programs and activities, and/or use of its facilities.

I understand that learners must remain on Temple Israel grounds and shared campuses from the time they arrive through their scheduled academic program unless they are part of an authorized, chaperoned activity. I give my permission for my learner to leave the grounds to participate in educational programs, under the supervision of the program staff.

Temple Israel has my permission to photograph and videotape my learner in any form of media and/or presentation of educational activities, and to reproduce and use such images in any of its advertising, publications, websites and social media pages such as Temple Israel Facebook pages and Twitter accounts, web based historical archive or the presentation of Temple educational programs to the community unless otherwise notified in writing by the parent/guardian.

I understand that Temple Israel believes in empowering our learners to be in charge of their bodies and that we ask for consent from our learners before we interact physically (hugs, fist bumps, high fives, etc.) and teach our learners to do the same.

I understand that the email information of parent/guardians may be distributed to other learners’ families at the school’s discretion.

The costs of first-aid and minor medical care performed on the premises, and not requiring a physician, are covered by the tuition fee. The costs of all other medical care and associated services are the financial responsibility of the learner's legal guardian.

I understand that Temple Israel is unable to adjust or refund any education program fees once my child is enrolled; I (we) are responsible for the entire year’s tuition.

I have read through the Family Packet, available to access here.

Electronic signature:

Please type your full name

Date:

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Tuition and Payment Information

Base tuition charge:

$

I would like to pay via:

Credit CardACH/Check

Parent/Guardians have the option to pay via credit card or eCheck. If paying by credit card, an additional non-refundable 3% of total tuition will be added to cover processing fees.

Amount pre-rounding:

For my tuition payments, I would like to:

Salesforce invoice amount

Amount to be charged today:

$

Credit Card Information

Card number:

Exp. Month:

Exp. Year:

CVV:

ACH/Check Information

Routing number:

Account number:

Bank account type:

Bank name:

Account holder name:

Please only input one first name and one last name. Typing multiple names, I.E. "Bob and Linda Johnson" is an invalid entry and will cause your payment to error out.

Billing street address:

If you have a suite, apartment, or unit number, please include it here.

Billing city:

Billing state:

Billing ZIP:

Important note: If you are submitting applications for more than one learner today using the same payment method, sometimes our payment processing vendor flags those different submissions as duplicate which causes your application to error out.

An easy workaround to prevent your second or third application submission from erroring out is to change an abbreviation of the Billing Street Address line field, I.E. "South" to "S", or "Avenue" to "Ave", etc., to make your second submission slightly distinct from your first.

It's an issue that has been brought to the attention of Authorize.Net, but can be prevented in the mean time with this workaround.

IMPORTANT INFORMATION ON SCHOLARSHIP APPLICATION:

We never want finances to be an obstacle to Jewish education at Temple Israel. If you would like to apply for a scholarship:

Please complete the Temple Israel Scholarship Request Form as soon as possible after submitting your program registration (but no later than July 15, 2026). If you wish to complete this application right away after submitting this form, right-click the link above and open the form in another tab. Please submit the program registration form first before submitting your scholarship request.

Once your scholarship application has been approved, the rest of your monthly payments will be adjusted accordingly and the payment method on file will be processed. If you have questions, please reach out to the accounting department at accounting@templeisrael.com.

7th Grade JEWL Students

You are now ready to click Submit!

PLEASE DO NOT SUBMIT THIS FORM MULTIPLE TIMES IF YOU ENCOUNTER AN ERROR.

Please contact jschwarzkopf@templeisrael.com with a screenshot or the specific error message language you received and we will assist you as soon as possible.

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