Lessons Application Form

Address*

Family Information
Father's Name*
First Name Last Name
Father Jewish*

YesNo
Father's Cell*
Father's Email*
Mother's Name*
First Name Last Name
Mother Jewish*

YesNo
Mother's Cell*
Mother's Email*
Marital Status*
Any conversions in the family?* If yes, please email the conversion certificate to [email protected]
Cancellation Policy:

A cancellation can be made up to 12 hours before the lesson, and there will be no charge. Lessons cancelled with less than 12 hours notice will be charged at the regular lesson rate.
I agree and accept the cancellation policy*

Yes
Please share anything you feel would be helpful for us to know about your child.
Once you submit the form, the Rabbi will be in touch to confirm acceptance, answer any questions, and discuss a lesson schedule that works well for your son.
Should be Empty:

This page uses TLS encryption to keep your data secure.

Bar Mitzvah Lessons Application Form