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Bat Mitzvah Club

ב"ה

Sign Up

Our meetings will be virtually on Tuesday evenings (once a month)
at 6:30 pm-8:00pm on April 13, May 11 and June 8.
Full Name*

First Name Last Name
Hebrew Name
Father's Name*
Mother's Name*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Number*

Area Code Phone Number
E-mail*
Birthday*

Month Day Year
Age*
Current School*
Current Grade*
Have there been any conversions in the family?*

Yes No
If yes, please elaborate:
Tell us a little about yourself...
What are your favourite subjects at school?*
What are your favorite activities?*
What do you do in your free time?*
Names and ages of other siblings:*
I would like to join the Bat Mitzvah Club because...*
For Parents
I am able to volunteer my time to help at BMC if needed:*

Yes No Maybe
Father's E-mail*
Mother's E-mail*
Bat Mitzvah Girl's E-mail*
Registration

$360 Full year $180 Partial year $49 Subsidized cost
Total

$0.00

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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