Bar Mitzvah Application Form

We are very excited to help prepare your son for this special milestone and make his Bar Mitzvah a meaningful and memorable experience.

If you are also looking to celebrate your son's Bar Mitzvah with us at the Shul, we'd be delighted to help. Please email [email protected] for more information and to secure a date.
Student Profile
Full Name*
First Name Last Name

Home Address*

Date of Birth*

Month Day Year
Hebrew Name (If Known)
Current School*
Grade Entering*
Hebrew Reading Proficiency*

NoneSomewhatWell
Previous Jewish Education*

YesNo
If yes, where?
Parents' Information
Father's Name*
First Name Last Name
Father's Hebrew Name (If known)
Father's E-mail*
Father's Cell*

Area Code Phone Number
Mother's Name*
First Name Last Name
Mother's Hebrew Name (If known)
Mother's E-mail*
Mother's Cell*

Area Code Phone Number
Is the mother of the child Jewish?*

Jewish by birthConverted
Are there any conversions in the family?*

YesNo
If yes, please explain:
Classes will take place on:

October 15 and 29

November 12 and 26

December 10

January 7 and 21

February 11 and 25

March 11

Father and Son bagels and lox Shul tour- Sunday April 4
Price

$500
Order a pair of Tefillin with a personalized bag: We highly encourage that you buy Tefillin. Tefillin costs $700.

Yes!
Total

$500.00

Payment*

Credit Card Check or Apply for full or partial scholarship using the above information

Postal / Zip Code

Country

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We are very excited to help prepare your son for this special milestone and make his Bar Mitzvah a meaningful and memorable experience.