Grades 7-12 (Team Tikkun) Religious School Application
Child's First and Last Name
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Child's Hebrew Name
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Child's Date of Birth
MM
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DD
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YYYY
Gender
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Home Address
Please provide street address, city, state and zip
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Home Phone Number
Please use this format 111-111-1111
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Child's Cell Phone Number
Please use this format 111-111-1111
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Does Your Child Have Any Allergies?
What is your child allergic to?
Please specify
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