Gesher LaTorah 2023/24 Returning Student Registration Check

Student's Name Student's Name First Last
Email of person completing form:
Please check one of the following

Please check one of the following I have reviewed the information you currently have on file for my child and there are no changes. I have reviewed the information you have on file for my child and I will list any changes and updates below (changes may include contact information, medical history, etc.).
Changes/updates
Do you receive Self-Directive funding?

Do you receive Self-Directive funding? Yes No
If you receive self-directive funding, you are not required to submit payment at this time.
Are you requesting Financial Aid?
I am registering the student for the following:

I am registering the student for the following: Sunday - 2 hours (Tuition $575) Sunday - 3 hours (tuition $800)
I am paying

I am paying Mandatory Registration Fee - $100 Full Tuition - $575 or $800 Other Amount
Amount you are paying: $ Dollars . Cents
Is the student fully vaccinated against COVID-19?

Is the student fully vaccinated against COVID-19? Yes No
Please explain
In order to mitigate the incidents of non-COVID-19 illnesses, health officials are strongly encouraging all participants to ensure they are up-to-date on all vaccines, including the seasonal flu vaccine. Is the student current on all vaccines?

In order to mitigate the incidents of non-COVID-19 illnesses, health officials are strongly encouraging all participants to ensure they are up-to-date on all vaccines, including the seasonal flu vaccine. Is the student current on all vaccines? Yes No
My signature below indicates my understanding that I will make the check payable to The Associated and mail a check for tuition to Jewish Educational Services, 5708 Park Heights Ave, Baltimore, MD 21215. Please mark in the memo that it is GLT Tuition.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Gesher LaTorah 2023/24 Returning Student Registration Check

Gesher LaTorah 2023/24 Returning Student Registration Check

If you receive self-directive funding, you are not required to submit payment at this time.