Our Tent Registration 2022-23 Trimester 3

Welcome

Welcome

IF YOU ARE A MEMBER, PLEASE LOGIN.

This will insure proper credit to your account. Login at the top right corner. If you are accessing this form through your phone, click the 3 line menu at the top right corner.

ATTENTION MAC USERS! PLEASE USE CHROME OR FIREFOX BROWSER AS SAFARI PRODUCES ERRORS.

IF YOU HAVE ANY DIFFICULTY REGISTERING, PLEASE CONTACT CHARLOTTE VERSAGI (cversagi@suburbantemple.org) VIA EMAIL. THANK YOU!

IF YOU ARE IN 8TH - 12TH GRADE YOU SHOULD SIGN UP TO BE A LEARNER FOR ONE SESSION AND TO BE A MADRICH/A FOR THE OTHER LEARNING SESSION

So that we can keep bringing you quality innovative programs, this year we will begin charging our adult learners a nominal fee for the classes they attend. Each course you register for will cost $36. If, however, you have a child enrolled in the program, we will wave this fee! Please make sure you fill out the tuition part of this form.
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PHOTO RELEASE

Photo Release

Yes, I give my permission to use my or my family's pictures or likenessesNo, I do not give permission to use my or my family's pictures or likenesses.Photos may be used in the Suburban Temple-Kol Ami newsletter, website, Facebook pages, other social media, and in local newspapers. My permission shall remain in effect unless revoked by me and communicated to Suburban Temple-Kol Ami in writing.

LEARNER INFORMATION

* Describe your family.

Household Address

Household City

* Household Zip Code

LEARNER ENROLLMENT

Learner # 1

Learner #1 First Name

Learner #1 Last Name

Email for Learner # 1

Learner # 1 Phone (Mobile Preferred)

Learner # 1 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 1 Grade (12th Grade or below)

* Session 1 Learner #1

* Session 2 Learner # 1

For this trimester I would like to learn...

Learner # 2

Learner #2 First Name

Learner #2 Last Name

Learner #2 Email

Learner # 2 Phone (Mobile Preferred)

Learner # 2 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 2 Grade (12th Grade or below)

* Session 1 Learner # 2

* Session 2 Learner # 2

For this trimester I would like to learn...

Learner # 3

Learner # 3 First Name

Learner # 3 Last Name

Learner #3 Email

Learner # 3 Phone (Mobile Preferred)

Date of Birth Learner # 3 (12th Grade or below)

mm/dd/yyyy

Learner # 3 Grade (12th Grade or below)

* Session 1 Learner # 3

* Session 2 Learner # 3

For this trimester I would like to learn...

Learner # 4

Learner # 4 First Name

Learner #4 Last Name

Learner # 4 Email

Learner # 4 Phone (Mobile Preferred)

Learner # 4 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 4 Grade (12th Grade or below)

* Session 1 Learner # 4

* Session 2 Learner # 4

For this trimester I would like to learn...

Learner # 5

Learner #5 First Name

Learner #5 Last Name

Learner #5 Email

Learner # 5 Phone (Mobile Preferred)

Learner # 5 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 5 Grade (12th Grade or below)

* Session 1 Learner # 5

* Session 2 Learner # 5

For this trimester I would like to learn...

LEARNER'S MEDICAL AND CONFIDENTIAL INFORMATION FORM

ALL (including adults) learners must complete this form.

** CLICK HERE FOR MANDATORY MEDICAL/CONFIDENTIAL FORM **

COME BACK TO CLICK ON THE LINK ABOVE AFTER YOU COMPLETE ENROLLMENT.

LEARNER'S TUITION

The tuition structure for both members and non-members is below. Please also consider making an additional gift in support to Our Tent.

Please indicate the number of learners in each category in the boxes below.

ST-KA K-12th Grade Learner

ST-KA Adult Learner (no children enrolled) - CHOOSE THE NUMBER OF TOTAL COURSES THIS TRIMESTER FOR ALL LEARNERS THAT QUALIFY IN THIS CATEGORY

ST-KA Adult Learner (with children enrolled)

Non-Member

Torah Tots

DONATE TO OUR TENT!

MAKE A DONATION!!! SPONSOR OUR TENT!!!

For $360 you can sponsor 1 full class for a trimester.
For $72 you can sponsor a single class.
You can also do a Tribute in Honor of a Teacher!

Our Tent Class $360Single Class $72

Type any dedication, teacher appreciation or note here.

Other

Donate any amount. Enter with no $.

Total

If you have not already done so, don't forget to click link for Learner medical form after you submit registration. Your registration is not complete unless the Medical Information form is completed.

https://www.suburbantemple.org/form/our-tent-Learner-medical-information-.html

Mon, February 6 2023 15 Sh'vat 5783