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Nosh & Drash Monday Night School Registration 2018-2019
A deposit of $100 per student is due upon completion of this form.
Total tuition due is $400/yr for members of a Conservative congregation, and $475/year for others.
Scholarship forms must be returned to Carma Gargaro at Adat Shalom Synagogue (
cgargaro@adatshalom.org
). An application form is located online at
http://adatshalom.org/wp-content/uploads/2018/04/scholarship-18-19.pdf
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Student 1 Information
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Student 1 Name (first and last)
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Gender
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Male
Female
Other:
Grade in Sept. 2018
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Choose
8th
9th
10th
11th
12th
School
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Birthdate
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DD
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YYYY
Student cell phone
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Student Email Adress
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Student 1 Dietary needs (check all that apply)
Gluten Free
Dairy Free
Vegetarian
Vegan
Other:
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