2022-23 B'Yachad Registration

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Join B'Yachad 2022-23!

Join us for the inaugural year of Sinai Temple and Temple Beth El's new joint school!

This form is divided into four sections:

Student Registration and Enrollment Information
Hebrew Learning Options
Jewish Enrichment Afterschool Program Registration
Payment Options

As you make your way through the form, take your time and answer questions to the best of your ability. If you run into any questions or concerns, please do not hesitate to reach out to Molly Bajgot, B'Yachad Director, at director@byachadspringfield.org.

We look forward to a year of learning and celebrating with your family and your students!

*Please Note: our Pre-K class is now full! You can register below to be added to our waitlist.

Welcome!

Section 1: Student Registration and Enrollment

* Has your family been enrolled in the religious school of either Sinai Temple or Temple Beth El previously?

Please Select OneYes, Temple Beth ElYes, Sinai TempleNo

* Are you interested in Temple Membership?

Section 1A: Family or Caregiver Contact Information

* First Name (Primary)

* Last Name (Primary)

* Email (Primary)

* Phone (Primary)

* Relationship to Student(s) (Primary)

* Street Address (Primary)

Street Address Line 2 (Primary)

* City (Primary)

* State (Primary)

* ZIP (Primary)

* Is there a secondary contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf there is a secondary contact, all emails and mailings will go to both contacts. In case of urgent need, the primary contact will be notified first

* First Name (Secondary)

* Last Name (Secondary)

* Email (Secondary)

* Phone (Secondary)

* Relationship to Student(s) (Secondary)

* Street Address (Secondary)

Street Address Line 2 (Secondary)

* City (Secondary)

* State (Secondary)

* ZIP (Secondary)

* Is there a third contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf there is a third contact, all emails and mailings will go to all contacts. In case of urgent need, the primary contact will be notified first

* First Name (Third Contact)

* Last Name (Third Contact)

* Email (Third Contact)

* Phone (Third Contact)

* Relationship to Student(s) (Third Contact)

* Street Address (Third Contact)

Street Address Line 2 (Third Contact)

* City (Third Address))

* State (Third Contact)

* Is there a fourth contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf there is a fourth contact, all emails and mailings will go to all contacts. In case of urgent need, the primary contact will be notified first

* First Name (Fourth Contact)

* Last Name (Fourth Contact)

* Email (Fourth Contact)

* Phone (Fourth Contact)

* Relationship to Student(s) (Fourth Contact)

* Street Address (Fourth Contact)

Street Address Line 2 (Fourth Contact)

* City (Fourth Address))

* State (Fourth Contact)

Section 1B: Emergency Information

* Emergency Contact Name

* Emergency Contact Best Phone

* Emergency Contact Relationship

Family Physician Name

Family Physician Phone Number

Hospital Preference

Section 1C: Student Enrollment Information

Our school has a sliding scale for tuition that is informed by our Jewish values. Below we ask that you decide what tuition rate is financially feasible and meaningful for you to contribute in this coming year.

We ask our families to consider what they can financially contribute to our community's Jewish education program and, where feasible, choose a level of support above the base rate, a nediv lev, or gift of the heart. This will sustain B'Yachad and ensure it's financial health, provide scholarship for those who need it, and create better programming opportunities for our students.

To read more about our decision to develop a sliding scale tuition rate for B'Yachad, view our Tuition Guide to help you choose your rate, and to learn about the Jewish values that informed this decision.

Scholarship is available for families who are members of either Sinai Temple or Temple Beth El. Scholarship applications will be made available to those who indicate their interest in receiving one on this form.

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate (MM/DD/YYYY)

* Student 1's Grade as of Fall 2022

* Student 1 Hebrew Name

What pronouns does your child use?

She/herHe/himThey/themOther

* Student 1 Preferred Name

Student 1 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 1 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 1 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* Student 1 Learning Needs: What should we know about your child in a classroom setting? How do they learn best and what kind of supports can we provide?

* Student 1: Does your child have a formal IEP or 504 plan?

Please Select OneYesNo

If applicable, upload your student's IEP file here

If you have access to your student's IEP, please upload here for their teacher to review

Student 1: Enter Kindergarten Through 2nd Grade Tuition

Kindergarten - 2nd Grade:
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

Student 1: Enter 3rd through 7th Grade Tuition

3rd - 7th Grade
Temple members: $800 - $1,800 or more
Non-members: $1,160 - $ 1,800 or more

Student 1: Enter High School Tuition

High School
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

At this time, our Pre-K class is full. Thank you for your interest! Your family will be added to a waitlist.

Tuition is free for Ages 3.5-5, Pre K students. Families are welcome to choose to give a nediv lev, a gift of the heart, as contribution towards tuition costs.

I would like to apply for a needs-based scholarship from my home synagogue

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

* Student 2 Birthdate (MM/DD/YYYY)

* Student 2's Grade as of Fall 2022

* Student 2 Hebrew Name

What pronouns does your child use?

She/herHe/himThey/themOther

* Student 2 Preferred Name

Student 2 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 2 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 2 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 2 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* Student 2 Learning Needs: What should we know about your child in a classroom setting? How do they learn best and what kind of supports can we provide?

Does your student have a formal IEP or 504 plan?

Please Select OneYesNo

Student 2: If applicable and accessible, upload your student's IEP file

Student 2: Enter Kindergarten Through 2nd Grade Tuition

Kindergarten - 2nd Grade:
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

Student 2: Select 3rd Through 7th Grade Tuition

1st - 7th Grade
Temple members: $800 - $1,800 or more
Non-members: $1,160 - $ 1,800 or more

Student 2: Enter High School Tuition

High School
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

I would like to apply for a needs-based scholarship from my home synagogue

Student 3 Information

* Student 3 First Name

* Student 3 Last Name

* Student 3 Birthdate (MM/DD/YYYY)

* Student 3's Grade as of Fall 2022

* Student 3 Hebrew Name

What pronouns does your child use?

She/herHe/himThey/themOther

* Student 3 Preferred Name

Student 3 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 3 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 3 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 3 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* Student 3 Learning Needs: What should we know about your child in a classroom setting? How do they learn best and what kind of supports can we provide?

Student3: Does your child have a formal IEP or 504 plan?

Please Select OneYesNo

If applicable and accessible, upload your student's IEP file here

If accessible to you, please upload your student's IEP for their teacher to review

Student 3: Enter Kindergarten Through Second Grade Tuition

Kindergarten - 2nd Grade:
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

Student 3: Enter 3rd Through 7th Grade Tuition

3rd - 7th Grade
Temple members: $800 - $1,800 or more
Non-members: $1,160 - $ 1,800 or more

Student 3: Enter High School Tuition

High School
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

I would like to apply for a needs-based scholarship from my home synagogue.

Student 4 Information

* Student 4 First Name

* Student 4 Last Name

* Student 4 Birthdate (MM/DD/YYYY)

* Student 4's grade as of Fall 2022

* Student 4 Hebrew Name

* What pronouns does your child use?

She/herHe/himThey/themOther

* Student Preferred Name

Student 4 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 4 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 4 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 4 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* Student 4 Learning Needs: What should we know about your child in a classroom setting? How do they learn best and what kind of supports can we provide?

Student 4: Does your student have a formal IEP or 504 plan?

Please Select OneYesNo

If applicable and accessible, upload your student's IEP here

If you have access to your student's IEP, please upload here for their teacher to review.

Student 4: Select Kindergarten Through Second Grade Tuition

Kindergarten:
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

Student 4: Select 1st Through 7th Grade Tuition

3rd - 7th Grade
Temple members: $800 - $1,800 or more
Non-members: $1,160 - $ 1,800 or more

Student 4: Enter High School Tuition

High School
Temple members: $400 - $1800 or more
Non-members: $760 - $1800 or more

I would like to apply for a needs-based scholarship from my home synagogue.

Section 1D: Release Forms

* Contact Waiver: The Religious School has permission to share our contact information with our B'Yachad Religous School families

Please Select OneYesNo

* Media Release: From time to time your child's photo may be taken in our classrooms or at special events. We use these photos in our newsletters, on our website, in our Facebook posts and other publicity materials.

Please select oneI grant permission for my child(ren)'s image to be used in all mediaI grant permission for my child(ren)'s image to be used only in internal synagogue mediaI do not grant permission for my child(ren)’s image to be used

Section 1E: B'Yachad Family Programs & Support

Our B'Yachad family programs build relationships and infuse joy into our Jewish lives. Each year, we host B'Yachad Family Shabbat dinners as well as various family holiday programs. They cannot happen, however, without the support of our B'Yachad parents. Below, please indicate your interest and ability to volunteer to help make our Family Programs happen:

Yes! Just be in touch about whenNot sure yet, I need more informationNo, I will not be able to

PJ Library Subscription: PJ Library sends free, award-winning books that celebrate Jewish values and culture to families with children from birth through 12 years old. Would your family like to subscribe to receive PJ Library books?

Please select oneYes, we would like to subscribeWe are already subscribedNo, not at this time

Is there anything else you want us to know about you, your family, or your students as we enter into the school year?

Section 2: Hebrew Learning Options

B'Yachad offers weekly 30 minutes Hebrew tutoring for students grades 3rd-6th* to learn to decode and read the Hebrew language. For your students grades 3rd-6th, please indicate below their preference for Hebrew tutoring (in person or virtual, 1:1 or small group) and their scheduling availability to the best of your knowledge.

*7th grade students are coordinated separately, as they work with their Rabbi or B'nai Mitzvah tutor.

For students Pre-K - 2nd grade, skip down to Section 4.

Student 1: Name

Student 1: Grade

Student 1: Hebrew Learning Options

Virtual 1:1 Hebrew TutoringIn-Person 1:1 Hebrew TutoringIn-Person Small Group Hebrew TutoringUnsure at this time, please follow up with me

Student 1: Scheduling Availability (select all that apply)

Mondays between 3:30-6:30pmTuesdays between 3:30-6:30pmWednesdays between 3:30-6:30pmThursdays between 3:30-6:30pmSundays after B'Yachad, between 12:00-1:00 (in-person only)Unsure at this time, please follow up with me

Specific information about Student 1's Hebrew Learning needs, tutor requests, or scheduling preferences:

Student 2: Name

Student 2: Grade

Student 2: Hebrew Learning Options

Virtual 1:1 Hebrew TutoringIn-Person 1:1 Hebrew TutoringIn-Person Small Group Hebrew TutoringUnsure at this time, please follow up with me

Student 2: Scheduling Availability (select all that apply)

Mondays between 3:30-6:30Tuesdays between 3:30-6:30Wednesdays between 3:30-6:30Thursdays between 3:30-6:30Sundays after B'Yachad, between 12:00-1:00pm (in-person only)Unsure at this time, please follow up with me

Specific information about Student 2's Hebrew Learning needs, tutor requests, or scheduling preferences:

Student 3: Name

Student 3: Grade

Student 3: Hebrew Learning Preference

Virtual 1:1 Hebrew TutoringIn-Person 1:1 Hebrew TutoringIn-Person Small Group Hebrew TutoringUnsure at this time, please follow up with me

Student 3: Scheduling Preferences

Mondays between 3:30-6:30pmTuesdays between 3:30-6:30pmWednesdays between 3:30-6:30pmThursdays between 3:30-6:30pmSundays after B'Yachad, between 12:00-1:00pm (in-person only)Unsure at this time, please follow up with me

Specific information about Student 3's Hebrew Learning needs, tutor requests, or scheduling preferences:

Section 3: Jewish Enrichment After School Program

This Fall, B'Yachad is piloting a Jewish Enrichment Afterschool program that offers Jewish electives as a supplement to our weekly Sunday Jewish education program. This program will be open to 3rd-7th graders, with a leadership opportunity for 8th-12th graders as assistant teachers.

From survey results, we learned that Monday or Wednesday afterschool would be the best days for this program to take place. Families would be able to bring their students to the program as early as 3pm, when school gets out, and continue to drop them off throughout (we understand schools have different dismissal times, and families have different commutes). The program would then go until 6pm.

Our first Enrichment session would begin the week of 9/11 as a Chaggim (Holiday) Series. Students will participate in holiday baking, cooking, ritual object craft creation, and more.

Cost: We do not want cost to be a barrier to families being able to participate in this After School program. In order to cover costs, we are asking for $10/student per session, with our first Chaggim Series being 4-5 weeks, or $40-50

Indicate your family's interest below:

Registration for Jewish Enrichment After School Program:

Yes, I would like to sign my child(ren) up for this program, beginning with the Chaggim Series!I'm interested in signing my child(ren) up for this program but I'm not sure it works with our schedules at this timeI'm interested in signing my child(ren) up for this program but I need more informationI'm not currently interested in signing my child(ren) up for this program

Which day(s) of the week work for your family? (Choose all that apply)

MondaysWednesdays

Section 4: Payment Information

Thank you for joining us for B'Yachad Religious School 2022-23. Below you will find your total amount of tuition. Tuition will be billed at a later date. No money is due at this time.

Please indicate when you would like to pay, and in what form:

Please indicate if you would like to tuition pay once annually or in 9 monthly installments:

Please Select OneI would like to pay in fullI would like to pay in 9 monthly installmentsI am a Temple member and are applying for a needs-based scholarship.

Please select how you would like to pay at a future date:

Credit card (additional 3% fee)ACH (direct deposit via bank, no fee)Check (made out to B'Yachad and sent to Temple Beth El, Springfield)Cash (delivered to Temple Beth El during business hours)

Total Amount

Thank you!

Thank you for taking the time to enroll your student(s) in our B'Yachad Jewish Education program. Someone will follow up with you shortly to confirm payment methods and answer any questions you might have.

Wed, January 15 2025 15 Tevet 5785

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