Bar and Bat Mitzvah Initial Deposit Form

Bar and Bat Mitzvah Initial Deposit Form
We are so excited to be on this Bar/Bat Mitzvah Journey with you and your family!

This form serves as an agreement to the date you have been assigned. It affirms that your child will continue to be enrolled in Moadon between now and the Bar/Bat Mitzvah service.

In order to officially confirm the assigned date, please complete the brief form below and submit the required $500 deposit.

If you need to change the date, which we completely understand, please simply email us and we will work with you to find a mutually acceptable date.

Deposits are refundable up to 15 months prior to the Bar/Bat Mitzvah date and will be applied to the total fee, to be paid in the year prior to the Bar/Bat Mitzvah.

Again, thank you for choosing Makom! We look forward to continuing to learn with you and your child!

Rabbi Bravo, Sherry and the MakomNY Team
Bar or Bat Mitzvah Student Name 1*

First NameLast Name
Bar or Bat Mitzvah Student Name 2 (if twins)

First NameLast Name
Bar or Bat Mitzvah Date Assigned by Makom: *

MonthDayYear
Please be sure that this matches the date indicated in the email you received from Makom.
Time of Service Assigned by Makom: .*
Please be sure that this matches the time indicated in the email you received from Makom.
Parent 1 Name*

First NameLast Name
Parent 1 Email*
example@example.com
Parent 1 Cell Phone*

Area CodePhone Number
Parent 2 Name

First NameLast Name
Parent 2 Email
example@example.com
Parent 2 Cell Phone

Area CodePhone Number

Enter Deposit Amount*

Bar/Bat Mitzvah Deposit for One Child($500.00 one-time payment)

B'nai Mitzvah Deposit for Two Children($1,000.00 one-time payment)

Payment Method

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Should be Empty: