Register

Address*

Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Parents Information
Father's Name*
First Name Last Name
Father's Cell*

Area Code Phone Number
Father's Hebrew Name
Father Jewish status:*

BirthConversionNot Jewish
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother Jewish stauts:*

BirthConversionNot Jewish
Mother's Cell*

Area Code Phone Number
Have there been any adoptions or conversions in the family (e.g., the child, parents, grandparents)?

YesNo
If yes, please explain and indicate which synagogue the conversion took place:
E-mail*
I am willing to assist in school activities, please contact me
Payment
Tuition for JUDA is $750 for the year. This includes all materials as well as admission fees for special holiday events that take place during JUDA hours. Please contact us if you need financial assistance.
Registration Fee

$50
Total

$0.00

Payment

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Postal / Zip Code

Country

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