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B'nai Mitzvah Service Information Form
Please verify reCaptcha before submitting the form.
*
Celebrant First Name
Middle Name
*
Last Name
Bar/Bat Mitzvah Date and Location
Parents names:
Celebrant's Hebrew Name
*
Father's Hebrew Name
*
Mother's Hebrew Name
*
Email Address
*
Phone Number
*
Please list Siblings and ages
*
Please list Grandparents names. Kindly indicate the following: married, divorced, widowed, living or deceased
*
Please list Great-Grandparents names if desired. Please indicate the following married divorced widowed living or deceased.
*
JUDAIC GIFT - Only ONE gift is presented by all siblings, If your choice of gift is something other than the items listed below, please check with B’nai Mitzvah Coordinator Marla Bednarsh. The Talit will be placed on the child's shoulders by all the grandparents present. If there are no siblings or grandparents, appropriate substitutions can be made in consultation with the Clergy.
Candlesticks
Kiddush Cup
Mezuzah
Menorah
Havdalah Set
Tzedekah Box
Yad
*
Person presenting gift.
*
First Aliyah - Please list relationships (ie: Grandparents Myra & Benjamin Singer and Sarah & Herman Levine)
Second Aliyah - Please list relationships (ie: Aunt & Uncle Susie & Marc Cohen)
*
Tutor
Mon, October 7 2024 5 Tishrei 5785