Bar Mitzvah Lessons

Please fill your information below

Student Information

First Name *

Last Name *

Hebrew Name *

Gender

Birth Date *

Month

Day

Year

Birth Date Before Sunset *

School *

Previous Jewish Education

Street Address *

Street Address Line 2

City *

Postal Code *

State/Province *

Parents Information

Father

First Name *

Last Name *

Phone Number *

Email *

Gender

Mother

First Name *

Last Name *

Gender

Phone Number *

Is Jewish *

Hebrew Name

Additional Info

Does the child know how to read basic Hebrew? *

Is the Child a: *

Tribe (CRM)

Does your child own a pair of Teffilin? *

Yes

No, I would like the Rabbi's help in purchasing a pair

No, I will purchase a pair on my own

Are there any specific learning challenges or factors related to your child's education that you believe are important for us to know about?