HEBREW CAFÉ

First name:

Last name:

Email:

Mobile phone number:

I am a parent of a child in Temple Sinai School

YesNo

I am signing up for:

Learn to Read: 10:15-11:00amModern Conversational Hebrew 11:00-11:45am

M Fee

NM Fee

One class

One

Two classes

Two

AOne Total

First Name:

Last Name:

Email:

Mobile Phone Number:

Are they a member at Temple Sinai?

YesNo

Are they a parent of a child in Temple Sinai School

YesNo

They are signing up for:

Learn to Read: 10:15-11:00amModern Conversational Hebrew 11:00-11:45am

Hebrew

This program is open to all, even those with absolutely no Hebrew background. However, it will be helpful for the teacher to have some background information

What is their Hebrew level regarding speaking?

What is their Hebrew level regarding reading? Note that reading is not required and will not be focused on. All words will be provided in English transliteration (as well as in Hebrew).

MFee

NMFee

One class

One

Two classes

Two

ATwo Total

First Name:

Last Name:

Email:

Mobile Phone Number:

Are they a member at Temple Sinai?

YesNo

Are they a parent of a child in Temple Sinai School

YesNo

MFee

NMFee

One class

One

Two classes

Two

AThree Total

First Name:

Last Name:

Email:

Mobile Phone Number:

Are they a member at Temple Sinai?

YesNo

Are they a parent of a child in Temple Sinai School

YesNo

MFee

NMFee

One class

One

Two classes

Two

AFour Total

First Name on Card

Last Name on Card

Credit Card Number

Visa or MasterCard

Expiration Month

Expiration Year

CVV

Billing Address

Billing City

Billing Province

Billing Postal Code

Country

Authnet_Hidden_Fields

Outreach ID

Designation ID

Invoice Name

Invoice Req'd

YesNo

Invoice Description