ECC Bio Update
Thank you in advance for providing any updated and new information requested on this form.
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Email *
Child Information
Child's Name *
Child's Address (if changed from last year)
Child's Home Phone (if changed from last year)
Family Information
Home Address (if changed from last year)
Home Phone (if changed from last year)
Parent Marital Status (if changed from last year)
Parent/Guardian 1 Occupation (if changed from last year)
Parent/Guardian 1 Cell Phone (if changed from last year)
Parent/Guardian 1 Email (if changed from last year)
Parent/Guardian 2 Occupation (if changed from last year)
Parent/Guardian 2 Cell Phone (if changed from last year)
Parent/Guardian 2 Email (if changed from last year)
Child Resides With (if changed from last year):
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New Sibling Name and Date of Birth (if applicable)
Current Synagogue Affiliation (*please provide a copy of your most recent synagogue invoice, if applicable, to represent proof of membership) *
Grandparents' (if information changed from last year) Addresses
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