Gallery: Bat Mitzvah Club Parts 1,2 and 3
Application Form

Last Name

First Name

Hebrew Name

Father's Name

Mother's Name



Current School

Current Grade

Have there been any conversions in the family? Yes No

If yes, please elaborate:

Tell us a little about yourself...

What are your favourite subjects at school?

What are your favourite activities?

What do you do in your free time?

Names and ages of other siblings

I would like to join the Bat Mitzvah Club because...


For Parents

I am able to host the Bat Mitzvah program in my home Yes No

I am able to volunteer my time to help with driving Yes No


Father's E-mail Address:

Mother's E-mail Address:

Bat Mitzvah Girl's E-mail Address:


Total I am paying*
First Name*
Last Name*
Post Code*
Home Phone*

Card Type*
Card Number*
Expiration Date*
CVV Security Code*