B'nai Mitzvah Submission Form
Bar/Bat Mitzvah 1
*
First Name
Middle Name
Last Name
Bar/Bat Mitzvah 2 (if applicable)
First Name
Middle Name
Last Name
Date of Bar/Bat/B'nai Mitzvah
*
/
Month
/
Day
Year
Parent 1
First Name
Last Name
Parent 2
First Name
Last Name
Grandparent 1
First Name
Last Name
Grandparent 2
First Name
Last Name
Grandparent 3
First Name
Last Name
Grandparent 4
First Name
Last Name
Mitzvah project(s)
Tell us about the service project the bar/bat mitzvah is working on for their special milestone.
Additional family members (if applicable)
Notes/additional information (if applicable)
Photo:
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Providing a photo is optional, but we'd love to have one to include in our communications to the congregation!
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Name of person completing form
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First Name
Last Name
Email for receipt
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