B'nai Mitzvah -

Bar/Bat Mitzvah at Temple Beth Shalom

A 50% deposit is required to separate the date.

Please fill out the following form to inquire about your date.

Child's Information
Name*
First Last
Jewish Name*
Date of birth*
MM slash DD slash YYYY
Parents' Information
Parent A*
First Last
Parent A's Jewish Name*
Parent B*
First Last
Parent B's Jewish Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Synagogue affiliation*

Please enter name and city of your synagogue, or "none" if not affiliated with a congregation.
Training Details
Is or will your child be working with a rabbi, Hebrew teacher, or tutor?*
Your child is expected to be working with a local teacher. If distance training is required, this will need to be negotiated directly with the Rabbi.
Teacher or tutor's name*
First Last
Role*
Please describe*
Phone*
Email*
Event Details
Date of the event*
MM slash DD slash YYYY

Please provide approximate date if undetermined
Comments
Comments
This field is for validation purposes and should be left unchanged.