Hebrew Department Class Registration

Baruch HaShem Messianic Synagogue
6304 Belt Line Rd
Dallas,Texas 75254
(972) 386-0121
                                          
Semester & Year:  __________________________________


Student Name:  __________________________________     


DOB:  __________ (Children only, check:  ___Before or ___After Sunset)


Parent's Name:  _____________________________________________	BHS Member? ___________


Street Address:  _____________________________________________
  

City/State/Zip:  ________________________________________________


Telephone
Home:  _______________________ 	Work:  _______________________ 	Cell:  _______________________


Class Name:  ____________________________________________    Child Care Time: ___________________


Cost:  _____________ Check number:  ___________ Payment for multiple registrations?_____


Please submit payments to the Baruch HaShem office or place in an envelope with the registration 
form and drop it in the Tzedakah box.  Registration forms and payments may also be mailed to:   
				Baruch HaShem Messianic Synagogue
				Attn:  Hebrew Dept.
				6304 Belt Line Rd.
				Dallas, TX 75254

Please use a separate form for each class and for each student.  
Please pay by check if at all possible.  A single payment may be tendered if multiple 
registrations are paid at the same time (please attach all forms together with check).  

Download Extra Registration Forms at http://BaruchHaShemSynagogue.org/ministries/Hebrew/hebrew.html.
	
Tuition is refundable until date of 2nd class session.  Materials are non-refundable.

PLEASE NOTE THAT THE CLASS DATES AND TIMES ARE SUBJECT TO CHANGE!