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Bar Mitzvah Academy sign up

PARENT
Mother Name*
First NameLast Name
Mother Jewish?*
By birthBy choiceneither
Phone Number*
Area CodePhone Number
E-mail*
Father Name*
First NameLast Name
Father Jewish?*
By birthBy choiceneither
Phone Number*
Area CodePhone Number
E-mail*
SYNAGOGUE AFFILIATION
Child
Full Name
First NameLast Name
Grade entering and school*
Your son's Hebrew Reading level:*
wellsomewhatnone
Birth Date*
MonthDayYear
TIME OF BIRTH (REQUIRED TO CALCULATE JEWISH BIRTHDAY)*
Before sunsetAfter sunset
MAIN EXPECTATION:*
JEWISH HERITAGEBAR MITZVAH PREPSOCIAL JEWISH ENVIRONMENTALL

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Child cell Phone Number if applicable
Area CodePhone Number
Payment
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FEE SCHEDULE FOR THE YEAR
$400
A life cycle event form will need to be filled out & returned before your child can be accepted to Bar Mitzvah Academy.
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