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Youth Aleph Academy Registration Register Online

Register Online - Returning Students

Child's Name

First Name Last Name
Date of Birth

Month Day Year
Hebrew Name
Hebrew Birthday
School Attending
Current Grade

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
E-mail
Additional Comments
Signature
Payment Info
Payment Schedule
Total to be charged today

$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

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