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Registration for Bat Mitzvah Club


Dates: Dec 12th 2010 - May 15th, 2011

Family Name:


Home Phone:

Parent's Cell Phone :

Child's name:

Child’s Hebrew name:



Date of Birth:

Father’s First & Last Name

Mother’s First & Last Name:

Mother's E-mail:

Daughter's E-mail:

Does you child read basic Hebrew? None Somewhat Well

Does your child speak/understand Hebrew?
None Somewhat Well

Does your child have previous Jewish Education? Yes No

The Cost for the Bat Mitzvah Club is $80.00

Form of Payment

Card Number
Expiration Date Security Code

I will pay by check

(Please remit check to Chabad of Westborough, 54 South St, Westborough, MA 01581, and memo "Bat Mitzvah Club.")

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Chabad Hebrew School • 54 South Street • Westborough, MA 01581 • 508-366-0499 • All classes held at 276 Turnpike Rd, Westboro

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