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JVA Registration
Please fill out this form to register for 2023/2024
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Students first name
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Students last name
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Date of birth
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Students home address
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Students email address
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Mothers name
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Mothers phone number
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Mothers email address
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Fathers name
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Fathers phone number
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Fathers email address
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Your answer
What school did the student previously attend
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What Shul do you currently attend
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How did you hear about the Jewish Virtual Academy
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Gender
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