B'nai Mitzvah Change Request Form

B'nai Mitzvah Change Request Form

Please be patient, this request may take a few weeks to complete. We will be in touch if we need any additional information.
Child's Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Parent Name

First NameLast Name
Parent Email
example@example.com
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Town/City
Please provide the name of the town/city in which you live.
Name of the Elementary School your child attends or will attend
Name of the Middle School your child attends or will attend
Current B'nai Mitzvah Date

MonthDayYear
Date
Reason for change request
Please review the following information before deciding on what day you are requesting to change to.

Available: These dates are options for your child's B'nai Mitzvah in addition to the standard Saturday options. Dates in green are dates you likely were not aware were options.

Please note: Sundays will only be listed as available if a Rosh Chodesh falls on that date.

Unavailable: These dates aren't available for B'nai Mitzvah.

Restricted: These dates are available for B'nai Mitzvah but it may impact things like avaiable rental space for Kiddish after the service or where the B'nai Mitzvah can be held on that day.
Date(s) or date range you are requesting, please include the year.
Please provide as many dates or date ranges as possible.
Is there anything else you would like to share?
LOCATION PREFERENCE
First choice of location
Second choice of location
Should be Empty: