Register

JEMS Registration 2022-2023
We are currently accepting application forms for the 2022-23 school year. Classes are on Sundays from 10am-12pm beginning Sunday, September 11! Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, feel free to contact Rabbi Yishai at 248-390-5711 or email [email protected]
Child Profile:
Child 1
Child 1 Full Name*

First Name Last Name
Child 1 Hebrew Name
Child 1 Age*
Child 1 Birth Date*

Month Day Year
Child 1 School*
Child 1 Grade Entering*
Child 1 Previous Jewish Education if applicable
Child 2
Child 2 Full Name

First Name Last Name
Child 2 Hebrew Name
Child 2 Age
Child 2 Birth Date

Month Day Year
Child 2 School
Child 2 Grade Entering
Child 2 Previous Jewish Education if applicable
Child 3
Child 3 Full Name

First Name Last Name
Child 3 Hebrew Name
Child 3 Age
Child 3 Birth Date

Month Day Year
Child 3 School
Child 3 Grade Entering
Child 3 Previous Jewish Education if applicable
Parent Information:

Address*

Father's Name*

First Name Last Name
Father's Cell Number*

Area Code Phone Number
Father's E-mail*
Mother's Name*

First Name Last Name
Mother Born Jewish?*

Yes No Converted
Mother's Cell Number*

Area Code Phone Number
Mother's E-mail*
Emergency Information:
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
CONFIDENTIAL: Does your child have any allergies or other medical condition that we should be aware of? If yes, please describe them and indicate special precautions or care needed.
Please specify:
Grandparent Information:

We LOVE sharing smiles with the Grandparents. Help us spread Nachat by sharing the following information:
Grandparent 1 Name

First Name Last Name

Grandparent 1 Address

Grandparent 2 Address

Grandparent 2 Email
Payment :
We never turn down a family for financial reasons. Please be in touch with us to discuss scholarship options.

Full Tuition - $800
Sibling Discount - $50 off
NEW Student Half Price Special - $400 off
Refer a Friend Bonus - $100 off

Early Bird Discount until August 5 - $100 off

Bar Mitzvah class extension - additional $200 ($360 if not attending JEMS)
How many children would you like to sign up?
How would you like to pay

Pay entire amount now 8 month payment plan
Feel free to Check Us Out!

I would like my child to try out one session of JEMS Kids Club free of charge!
Total payment to be charged now

$
Optional Lunch n' Learn

I am interested in the possibility of an additional 12-12:30 Lunch n' Learn Please keep me posted for Lunch n' Learn Opportunities for PARENTS!
Total

$0.00

Payment

Credit Card

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JEMS @ The Shul
Jewish Education Matters