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Tefillah

All registrations submitted from August 10 will not be processed until after September 10.
We will then process the registrations in the order they were submitted.

 
REGISTRATION FORM
General Information
Where did you hear about us
Student's Information
Child's First Name *
Last Name *  
Gender * Male Female
Birth Date (MM/DD/YYYY) *  
Approximate time of day when born and location of birth
Child'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  *
Father Jewish By? *  Birth Conversion Other
Mother Jewish By? *  Birth Conversion Other
Family Information
Paternal Grandfather *  Jewish Converted Other
Paternal Grandmother *  Jewish Converted Other
Maternal Grandfather *  Jewish Converted Other
Maternal Grandmother *  Jewish Converted Other
Were there any adoptions in the family? *Yes No 
Additional Information
Which Nusach does your child Daven?
* = Required Fields

     
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