Early Childhood - Mini Mensches Spring Form - Form - Congregation Beth Ohr

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Kol Nidre 5784/2024

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Early Childhood - Mini Mensches Spring Form

Please verify reCaptcha before submitting the form.

Items with a * are required.

Primary #1

* First Name

* Last Name

Address

City

State

Zip

* Home Phone #

* Mobile Phone #

* Email Address

Business Phone #

Primary #2

* First Name

* Last Name

Address

City

State

Zip

Home Phone #

Mobile Phone #

* Email Address

Business Phone #

Number of Children

Child #1 Information

* First Name

Gender

* Date of Birth

Child's Hebrew Name

* Please select the days you will attend

Sunday, April 3Friday, April 8Sunday, April 10Friday, April 29Sunday, May 15Friday, June 17

Child # 2 Information

* First Name

Gender

* Date of Birth

Child's Hebrew Name

* Please select the days you will attend

Sunday, April 3Friday, April 8Sunday, April 10Friday, April 29Sunday, May 15Friday, June 17

Child # 3 Information

* First Name

Gender

* Date of Birth

Child's Hebrew Name

* Please select the days you will attend

Sunday, April 3Friday, April 8Sunday April 10Friday, April 29Sunday, May 15Friday, June 17

Child # 4 Information

* First Name

Gender

* Date of Birth

Child's Hebrew Name

* Please select the days you will attend

Sunday, April 3Friday, April 8Sunday, April 10Friday, April 29Sunday, May 15Friday, June 17

* Are you a member of CBO?

Please Select OneYesNo

How did you hear about this program?

Is there anything you would like us to know about you/your family?

Please note that in the case of inclement weather the class will be canceled.

Thu, April 25 2024 17 Nisan 5784

2550 South Centre Avenue

Bellmore, NY 11710

(516) 781-3072

Affiliated with United Synagogue of Conservative Judaism

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