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Aleph Champ
Bar Mitzvah Preparation
Registration Form
Jewish Kids Club
Contact
Register Now!
(702) 901-8383 ext 4
[email protected]
8551 Vegas Drive, Las Vegas, NV
Tuesdays and Thursdays 04:00PM to 07:00PM
Demo
Bar Mitzvah Preparation
"
*
" indicates required fields
Student Information
First Name
*
Last Name
*
Hebrew First Name
Hebrew Last Name
Date of Birth
*
MM slash DD slash YYYY
Bar Mitzvah Date
*
MM slash DD slash YYYY
School
Previous Jewish Education
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Parent's Information
Father's First Name
*
Father's Last Name
*
Phone
*
Email
*
Mother's First Name
*
Mother's Last Name
*
Phone
*
Email
*
Marital Status
*
Please Select
Married
Separated
Divorced
Can your child read basic Hebrew?
*
Please Select
Yes
No
Does your child own a pair of Teffilin?
*
Please Select
Yes
No, I would like the Rabbi's help in purchasing a pair
No, I will purchase a pair on my own.
Does the child have any learning challenges with generl stiduies? If yes, please share any relevant information.
Fees
Payment Period
*
Please Select
Yearly ($1500)
Monthly ($130)
Total Payable
Price:
$0.00
Credit Card
Cardholder Name
Card Details
