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Temple Shalom Religious School Student Information Form
Please complete the entire form and submit. Class assignments will not be made without a completed Student Information Form. (rev. June 2018)
Student's Name *
Your answer
Student's Street Address *
Your answer
Student's Hebrew Name
Your answer
Student's Zip Code *
Your answer
Student's City *
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Email Address *
Your answer
Student's Home Phone *
Your answer
Student's Cell Phone
Your answer
Student's Secular School in September 2018 *
Your answer
Student's Grade in September 2018 *
Your answer
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