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Bar Mitzvah Cheder Division
 
REGISTRATION FORM
General Information
Where did you hear about us
Student's Information
Son's First Name *
Last Name *  
Gender * Male Female
Birth Date (MM/DD/YYYY) *  
Approximate time of day when born and location of birth
Son's Current Grade  *  
Is your child .... *  existing student new student
Parents Information
Father's First Name *
Mother's First Name *
Address *
City *
State *
ZIP *
Country *
Home Phone *
Father Cell *
Mother Cell *
Father's Email  *
Mother's Email  *
Additional Information
Which school is your son currently attending? *
Phone number for your son's current school? *
What are you hoping your son will gain in this class? * 
Which days of the week would work best for your son?
Please include all possible days * 
Which times would work best?
Please include all possible hours. * 
I am also only/also interested in Bar Mitzvah tutoring? * 
Would you also be interested in our daily or weekly Cheder classes? *
* = Required Fields

     
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