Re-Registration Form for Shuir Beis & Gimmel - LM Chicago: 2026-2027

Re-Registration Tuition Form for Shuir Beis & Gimmel ONLY - LM Chicago: 2026-2027
If you have a son going into Shuir Alef please use the Shuir Alef Tuition Registration form for that son
Personal Information
Students First & Last Name*
First Name Last Name
Which Shuir will he be entering?*

Shuir BeisShuir Gimmel
Do you have a second returning student?*

NoYes
Second Student's First & Last Name*
First Name Last Name
Which Shuir will he be entering?*

Shuir BeisShuir Gimmel
Father's Title*
Father's First & Last Name*
First Name Last Name
Father's Email Address*
Father's Phone Number*
Mother's Title*
Mother's First & Last Name*
First Name Last Name
Mother's Email Address*
Mother's Phone Number*
Tuition
Please review the tuition details below.
Tuition Breakdown:

Tuition for year : $15,500
Dorm: $3,800
Food: $4,750
Summer Tuition: $2,200
Mikvah fee: $250
Trip & Activities Fee: $1,000
Administrative Fee: $250 (charged at the time of re-registration and is applied towards tuition if ALL forms are completed by by April 30th)
Tuition Total: $27,500

Total Tuition and Additional Fees: $27,500 ($27,750 if the forms are not completed before April 30th)
Tuition Affordability Gap: $12,500
Tuition Option: Please choose a tuition option from the dropdown.*

I agree to pay the full tuition and fees including the Tuition Affordability Gap totaling $40,000I agree to pay the full tuition and fees (after being adjusted for the Tuition Affordability Gap) totaling $27,500I would like to request a scholarship and my finacials are the same as last yearI would like to request a scholarship by filling out a scholarship form
Scholarship Form
This form does not guarantee a scholarship or any amount of scholarship.

The scholarship committee will review your submission and will send you a tuition bill that will reflect any potential scholarship.
Marital Status*

MarriedDivorcedWidowedSeparated
Father's Occupation:*
Father's Total Income (Yearly):*
Are you Self Employed*

YesNo
What Type of Business? If you own a business please write what type
Gross Annual Business:
Mother's Occupation*
Mother's Total Income (Yearly):*
Any additional income amount: * Does your household have any other sources of income? If yes, please explain and write amount.
Total income for family*
What was your total tuition bill from Mesivta last year, including all fees?*
How much of a scholarship are you requesting:* Please write the amount you are looking to have deducted from the full tuition amount of $27,500.
Please describe the reason for your scholarship request: * If there are any extenuating or special circumstances of which the tuition committee should be aware of in considering your application, please describe below.
Payment Plan:
*IMPORTANT: Please ensure that all payment information is fully completed. If you have any specific concerns or questions, kindly detail them in the notes section located at the bottom of this form. A member of our team will reach out to address your inquiries.
Please choose a payment schedule:* Payments are charged automatically based on your plan. The yeshiva does not manually initiate charges—please plan accordingly.

1 Payment Upfront - May qualify for a 7.5% discount if paid in full before June 1st3 Triannual Payments (Aug, Dec, & April)11 Monthly Payments (August - June)
Choose if you want to be charged on the 1st or 15th of the month*

1st15th
Payment Method
Please use this form to submit payment information securely. Please use only bank OR credit card information.
I would like to pay by:*

Bank AccountCredit Card(+3% fee)CheckZelle
Bank Account Information
Bank Name*
Account Type*

CheckingSavings
You will be sent a separate email requesting the bank account & routing number
Credit Card Information
A 3% fee will be added to your invoice if you pay with credit card when you make the administrative fee payment.
I understand that my total bill will be higher than last year due to the 2026 - 2027 tuition rate increase.*

Yes
Administrative fee for 2026 - 2027 School Year
There is a one time administrative fee of $250 per returning child for the 2026 - 2027 school year.

If all forms are completed by April 30th 2026 this $250 will be applied to 2026 - 2027 tuition
I agree to pay a one time administrative fee of $250 for the 2026 - 2027 school year.*

Yes
Administrtive Fee is $250 for each returning student*

$250 USD
Administrtive Fee is $250 for each returning student*

$500 USD

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Total

$0.00 USD
Yes, I'd like to donate the cost of processing this transaction by adding 3%
I will like this credit card to be used for tuition payments as well*

YesNo
Mailing Address
Is mailing address same as billing?*

YesNo

Mailing Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Partnership with LM Chicago
I would like to partner with Lubavitch Mesivta of Chicago to cover the cost of education.
The amount I would like to donate:

$18,000$12,500 - My son's tuition gap$1,800$720$540$360$180
Notes:
Should be Empty:

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Re-Registration Tuition Form for Shuir Beis & Gimmel ONLY - LM Chicago: 2026-2027

Personal Information

Tuition

Scholarship Form

Payment Plan:

Payment Method

Bank Account Information

Credit Card Information

Administrative fee for 2026 - 2027 School Year

Mailing Address

Partnership with LM Chicago