Enroll | Jewish Center of the Hamptons

Membership Status*

I am a Member
I am not a Member

Full Name (Parent/Guardian 1)*

First Name Last Name

Mobile Phone (Parent/Guardian 1)*

Email Address (Parent/Guardian 1)*

Full Name (Parent/Guardian 2)

First Name Last Name

Mobile Phone (Parent/Guardian 2)

Email Address (Parent/Guardian 2)

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Hamptons Address (if different from Mailing Address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Full Name (Student 1)*

First Last

Grade (Student 1)*

Program (Student 1)*

GOJL Pods (Kindergarten–Grade 6)
GOJL Online (Grades 4–7)

Semester (Student 1) Member*

Semester 2 ($500)

Semester (Student 1) Non-Member*

Semester 2 ($750)

Full Name (Student 2)

First Last

Grade (Student 2)

Program (Student 2)

GOJL Pods (Kindergarten–Grade 6)
GOJL Online (Grades 4–7)

Semester (Student 2) Member

Semester 2 ($500)

Semester (Student 2) Non-Member

Semester 2 ($750)

Full Name (Student 3)

First Last

Grade (Student 3)

Program (Student 3)

GOJL Pods (Kindergarten–Grade 6)
GOJL Online (Grades 4–7)

Semester (Student 3) Member

Semester 2 ($500)

Semester (Student 3) Non-Member

Semester 2 ($750)

Total

$0.00

Credit Card*

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MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

No child will be denied the opportunity to participate and learn with Gates of Jewish Learning due to financial constraints.

To arrange a payment plan, or if you require financial assistance, please contact our Financial Manager, Amy O’Sullivan, at aosullivan@jcoh.org or 631-324-9858. All arrangements will be made in the strictest confidence.

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