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Congregation Emanu-El Hebrew School/B'nei Mitzvah Registration Form 5783
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Email
*
Your email
Student 1 Name and pronouns:
Your answer
Student 1 Birthdate:
MM
/
DD
/
YYYY
Student 1 Hebrew Name:
Your answer
Student 1 School Grade
Your answer
Student 2 Name and pronouns:
Your answer
Student 2 Birthdate:
MM
/
DD
/
YYYY
Student 2 Hebrew Name:
Your answer
Student 2 School Grade
Your answer
Student 3 Name and pronouns:
Your answer
Student 3 Birthdate:
MM
/
DD
/
YYYY
Student 3 Hebrew Name:
Your answer
Student 3 School Grade:
Your answer
Student 4 Name and pronouns:
Your answer
Student 4 Birthdate:
MM
/
DD
/
YYYY
Student 4 School Grade:
Your answer
Student 4 Hebrew Name:
Your answer
Address (with postal code) and Home Phone:
Your answer
Second Address and Home Phone (if student lives at more than one address):
Your answer
Parent 1 Name and pronouns:
Your answer
Parent 1 Cell Phone:
Your answer
Parent 1 Work Phone:
Your answer
Parent 1 E-mail:
Your answer
Is Parent 1 Jewish?
Your answer
Parent 1 Hebrew Name:
Your answer
Parent 2 Name and pronouns:
Your answer
Parent 2 Cell Phone:
Your answer
Parent 2 Work Phone:
Your answer
Parent 2 E-mail:
Your answer
Is Parent 2 Jewish?
Your answer
Parent 2 Hebrew Name:
Your answer
Family Cell Phone or E-mail (if different from above):
Your answer
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