Hebrew Department Class Registration

Baruch HaShem Messianic Synagogue
6304 Belt Line Rd
Dallas,Texas 75254
(972) 386-0121
                                          


Student Name:  __________________________________  DOB: ______________  Grade: ______


Parent's Name:  _____________________________________________	BHS Member? ___________


Street Address:  _____________________________________________
  

City/State/Zip:  ________________________________________________


Telephone
Home:  _______________________ 	Work:  _______________________ 	Cell:  _______________________


Class Name:  ____________________________________________    Cost: _____________


Class Name:  ____________________________________________    Cost: _____________


Child Care Time: ___________________ (if applicable)


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


Please put payments 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 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 SCHEDULES ARE SUBJECT TO CHANGE!