YIKGH Membership Application
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Date
Name
Hebrew Name
Spouse
Hebrew Name
Address
Home Phone
Cell
Work#
E-mail Address
Spouse E-mail Address
Do you daven with the Young Marrieds minyan?
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Name Child #1
Age Child #1
Name Child #2
Age Child #2
Name Child #3
Age Child #3
Name Child #4
Age Child #4
Father's Yahrtzeit
Hebrew Date
Mother's Yahrtzeit
Hebrew Date
Dues $
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