Bnei Mitzvah Form
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Bar/Bat Mitzvah Child's English name *
Bar/Bat Mitzvah Child's full Hebrew name
Child's Birthdate *
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What time of day was the child born?
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Desired Date for the Bar/Bat Mitzvah
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Bar Mitzvah boys sometimes read from the Torah.  
In order to read from the Torah, a Bar Mitzvah boy must walk to shul on Shabbat morning. Please select one of the following options:
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Bar and Bat Mitzvah students sometimes deliver a Torah speech to the Congregation.
Bar and Bat Mitzvah students sometimes work on a Mitzvah project in preparation for their Bar/Bat Mitzvah.
Parents' Marital Status *
Mother's Name
Father's Name
Primary Contact *
Email *
Phone *
Have there been any conversions on either the father's or mother's side of the family in the past 3 generations? *
If there has been a  conversion, where was it performed, and who was the converting Rabbi?
Families celebrate in different ways.  Please ask us about options.
Questions, comments, concerns?
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