Bar/Bat Mitzvah Date Selection Form

* Parent 1 First Name:

* Parent 1 Last Name:

* Parent 1 Cell:

* Parent 1 Email:

Parent 2 First Name:

Parent 2 Last Name:

Parent 2 Cell:

Parent 2 Email:

Bar/Bat Mitzvah Age Children

* Name:

* Birthday

* Current Grade:

Name:

Birthday

* Current Grade:

Name:

Birthday

Current Grade:

Six BMitzvah Dates/Times From the List That Work for Me/Us Are:

Date 1

Time:

Date 2

Time:

Date 3

Time:

Date 4

Time:

Date 5

Time:

Date 6

Time:

NOTE: If you have a preferred day/time not listed as available, please list 6 available dates above, and then list your preferred dates and reasoning below:

I already have a date for my child's BMitzvah.

Please list date and time:

Date

Time:

I understand that in order to maintain fairness, 6 choices MUST be provided. Forms returned with less than 6 choices will NOT be processed. Forms that are turned in after the date below will only be processed AFTER all other forms are processed. I also understand that all Saturday morning and Saturday afternoon Havdala services will take place in our sanctuary. I understand that the temple will do everything it can to inform me of my child’s assigned BMitzvah date no later than mid-May 2022.

* Please write parent(s) full name(s) to acknowledge above agreement:

Please submit this form no later than April 14, 2022

Tue, May 13 2025
15 Iyar 5785

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Tue, May 13 2025 15 Iyar 5785

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