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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. July 2017)
Student's Name
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Student's Street Address
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Student's Hebrew Name
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Student's Zip Code
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Student's City
Student's Date of Birth
MM
/
DD
/
YYYY
Student's Email Address
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Student's Home Phone
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Student's Cell Phone
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Student's Secular School in September 2017
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Student's Grade in September 2017
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