South Shore USY                                                (Merrick, Bellmore, East Meadow)
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Email *
USYer's name *
USYer's Cell Phone Number *
Grade *
School *
Parent or Guardian's name(s)
Parent or Guardian's email
If your family belongs to a synagogue, please type its name below *
Have you been a part of our chapter in the past? *
Have you attended a meeting this year? *
Do you have any interest in taking on a leadership role in the chapter? *
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