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Bar & Bat Mitzvah

Bar & Bat Mitzvah Registration

Prior to registration we require an initial meeting to discuss what type of ceremony is best for you and your child.
To setup an initial meeting contact us at
407-636-5994
[email protected]
[email protected]
For FAQ on Bar or Bat Mitvzah information click here.
Student Profile
Full Name*
First NameLast Name
Hebrew Name*
Date of Bar/Bat Mitzvah Requested*
MonthDayYear
Date of Birth*
MonthDayYear
Current School*
Grade Entering*
Hebrew Reading Proficiency*
NoneSomewhatWell
Previous Jewish Education*
YesNo
Where?
Parent's Information
Father's Full Name
First NameLast Name
Father's Hebrew Name
Father's Phone Number
Area CodePhone Number
Father's E-mail
Mother's Full Name
First NameLast Name
Mother's Hebrew Name
Mothers Phone Number
Area CodePhone Number
Mother's E-mail
Are both the natural father and mother of the child Jewish?*
YesNo
If no, please explain*
Are there any conversions in the family?*
YesNo
If yes, please explain*

Address*

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

Other Comments & Details
Payment
Tutoring Lessons - $1000 for all one-on-one classes. Includes 12 Lessons to prepare for Bar or Bat Mitzvah. Any additional lessons requested will be charged $100 each.
Payment Options*
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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