Bar Mitzvah Registration Form

Father's Full Name*

First Name Last Name

Father's Hebrew Name

Father's Cell #*

Area Code Phone Number

Father's Email*

Mother's Full Name*

First Name Last Name

Mother's Hebrew Name

Mother's Cell #*

Area Code Phone Number

Mother's Email*

Address*

Siblings of Bar Mitzvah Boy Please include ages

Is the Father Jewish?*

Yes No

Is the Mother Jewish?*

Yes No

Marital Status of Parents*

Married Divorced Separated

Any conversions in the family?*

Yes No

Please explain the conversions in the family*

Bar Mitzvah Boy* First Name

Hebrew Name

Current Hebrew School/Synagogue*

Birth Date*

Month Day Year

Bar Mitzvah date will be reserved only after meeting with the Rabbi.

Bar Mitzvah Date Preference*

Month Day Year

Please Indicate* May pick more than one

Shabbat Morning & Kiddush Luncheon Monday or Thursday - 7:30am with congregation Monday or Thursday - Separate Service (anytime between 8am-10am)

Approximately how many people to you expect to attend?*

Comments

Family Information