New Families Exploratory Application

Thank you for interest in Park Hebrew. We are currently accepting application forms for the 2026-27 school year.

1. Fill out the exploratory application form. We'd love to get to know about your child and their needs.
2. Once your form is received, we will review your application and be in touch within 48 hours to schedule an exploratory phone call. (Filling out application does not guarantee a spot)

Name and Address

Household Name *

Email *

Street Address (Home) *

City (Home) *

Postal Code (Home) *

Country (Home) *

State (Home) *

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact relation to student(s) *

Mother or Parent #1 Information

Name *

Email *

Cell Phone *

Was the biological mother of the child born Jewish? *

Yes

No

Child #1 Information

Child's Name *

Hebrew Name *

Birth Date* *

School your child attends *

Grade entering *

Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed. *

Child #2 Information

Child's Name

Hebrew Name

Birth Date

School your child attends

Grade Entering

Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

General Information

Are there any adoptions or religious conversions in the family ( Ex: parents, grandparent, child)? *

Yes

No

If you answered yes to the above, please indicate who is adopted or converted and by which Beit Din

Is there anything else you'd like us to know about your child/children?

Be a part of it! Does either parent have a skill or resource they would like to volunteer/offer to Park Hebrew?

Chabad Lincoln Park