Tri-Valley Cultural Jews Enrollment Form
Questions?
If you would like to be contacted to discuss your questions before becoming a member, please click here:
https://goo.gl/forms/IKeVOhZoWrxhzzFA3
Personal Information
Adult #1 Name *
Your answer
Adult #1 Nickname
Your answer
Adult #1 Birthdate (mm/dd)
Your answer
Adult #1 Email Address *
Your answer
Adult #2 Name
Your answer
Adult #2 Nickname
Your answer
Adult #2 Birthdate (mm/dd)
Your answer
Adult #2 Email Address
Your answer
Home Address
Your answer
City, State, Zip
Your answer
Home Phone
Your answer
Other Phone
Your answer
Which activities in the organization would you like to participate in?
Is your home available for events?
How did you hear about our organization?
Your answer
Yortseits you'd like us to remember (name, date and relationship to you):
Your answer
Would you like to enroll your children in the Jewish Culture School at this time?
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