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Apply for Supervision
Submission of this form serves as an affirmation that the answers provided are truthful to the best of your knowledge. This application does not entail any commitment upon the Rabbinical Council of Bergen County.
After completing this form, please call Rabbi Rosenbaum at 201-837-1967 in order to continue the application process.
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Email
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Your email
Name of applicant
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Your answer
Phone number of applicant
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Your answer
Address of applicant
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Your answer
Name of Establishment
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Your answer
Address of the Establishment
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Your answer
Name(s) and contact info of active or silent partners
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Your answer
Type of Establishment
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Dairy
Meat
Retail
Are any individuals listed on this application have a private label? If yes, under what name?
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Your answer
Are any individuals listed on this application not Jewish?
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Yes
No
Are any individuals listed on this application operate other food establishments? If yes, please list them
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Your answer
Are any individuals listed on this application members of a synagogue? If yes, please provide name of synagogue, name of rabbi, and rabbi's contact info.
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Your answer
Please provide two business references with their contact information
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Your answer
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