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Family Information Form

Family Information Form

We are a Community Shul - 'where everyone is family'. Let us know about the people and dates that important in Your life, so we can be able to best serve you.

 Family Information Form 

 



Husband Information

Full Name

Hebrew Name

 Home Phone

 Cell

 Email

Address

 City/State

 Zip Code

 Cohen Levi Israel

 Bar Mitzvah Parsha

English Birthday

 

After night fall

Hebrew Birthday

 

 Click here for your Hebrew Birthday

 Profession

  

 

Wife Information

Full Name   

Hebrew Name

 Home Phone

 Cell

 Email

Address (if different)

 City/State

 Zip Code

Anniversary

 

English Birthday

 

After night fall

Hebrew Birthday

 

 Click here for your Hebrew Birthday

 Profession

  
 


Child Information 

Full Name   

Hebrew Name

English Birthday

 

After night fall

Hebrew Birthday

 

 Click here for your Hebrew Birthday

 

Full Name   

Hebrew Name

English Birthday

 

After night fall

Hebrew Birthday

  

 Click here for your Hebrew Birthday

 

Full Name   

Hebrew Name

English Birthday

 

After night fall

Hebrew Birthday

 

 Click here for your Hebrew Birthday

For additional children, please use this box to fill in the above mentioned information.

 

 Yartzeit Information

Full Name   

Hebrew Name

English Date

  

 

After night fall

Hebrew Date

  

 

 Click here for to Convert Hebrew Date 

 

Full Name    Hebrew Name
English Date  

After night fall

Hebrew Date

 

 Click here for to Convert Hebrew Date

 

Full Name    Hebrew Name
English Date  

After night fall

Hebrew Date

 

 Click here for to Convert Hebrew Date

 

Full Name   

Hebrew Name

English Date

 

After night fall

Hebrew Date

 

 Click here for to Convert Hebrew Date

 

Programs that would interest me 

Daily Minyan

Book Club

Shabbat Services

Chai Club

Jewish Women's Circle

Adult Education

Men's Club

Hebrew School

 

 

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