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Registration

HEBREW SCHOOL REGISTRATION
Child's Name

First Name Last Name
Hebrew Name
Birth Date

Month Day Year
School
Previous Jewish Education
Grade entering

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Additional notable Information
Parents Information
Father's Name

First Name Last Name
Father Cell

Area Code Phone Number
E-mail
Mother's Name

First Name Last Name
Mother Cell

Area Code Phone Number
E-mail*
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Payment - Please call 575-524-1330
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