Bat Mitzvah Club

Bat Mitzvah Club Meeting Dates:
January 9, 16, 30
February 6, 13, 20, 27
March 5, 12 (Mother Daughter Challah Bake), 26
April 2 - Bat Mitzvah Ceremony
Bat Mitzvah Girl Info
Girl's Name*

First Name Last Name
Birth Date* Time can be approximate.

Month Day Year
at Hour Minutes
School attending* as of September 1, 2023
Grade* as of September 1, 2023
Girl's Hebrew Name (if known)
Mother's Hebrew Name (if known)
Family Info
Father's Name*

First Name Last Name
Is Father Jewish?*

YesNo
Mother's Name*

First Name Last Name
Is Mother Jewish?*

YesNo
Were there any conversions in the family?*

YesNo
If so, please explain:*
Best Contact Number*

Area Code Phone Number
Best Contact Email*
Payment Info
Register*

$450
Total

$450.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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