Printed fromJewishYonkers.com

Chabad Hebrew School

Inspiring Jewish Pride and Identity in Jewish Children - the future of Judaism.

ב"ה

Bar Mitzvah / Bat Mitzvah Class, Registration

Bar Mitzvah / Bas Mitzvah Class, REGISTRATION
Child's Name*

First Name Last Name
Hebrew Name*
Birth Date*

Month Day Year
School*
Previous Jewish Education*
Grade entering*

Address*

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

Additional notable Information
Parents Information
Father's Name*

First Name Last Name
Father Cell

Area Code Phone Number
Mother's Name*

First Name Last Name
Mother Cell

Area Code Phone Number
Payment
Registration Fee

$150
Total

$0.00
Double-click to edit this text...

Payment

Credit Card Paypal Other

Postal / Zip Code

Country

Should be Empty:

This page uses TLS encryption to keep your data secure.