Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Child's name:

City of residence:

Parents' names:

City of residence:

Date and location of bar/bat mitzvah:

Family members joining simcha:

Brothers:

Sisters:

Living grandparents:

City of residence:

Child's grade, school & school's location

Twinning/sharing:

B'nai Mitzvah project:

Additional comments:

Add photo (please include caption):

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