SOMA USY & Kadima Application

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IF YOU ARE A MEMBER, PLEASE LOGIN.

This will insure proper credit to your account. Login at the top right corner. If you are accessing this form through your phone, click the 3 line menu at the top right corner.

First Name

Last Name

E-mail

Street Address

Home Phone

Your Cell

School Name

Birthday

Are you a member of Beth El

If not, do you belong to another synagogue

Parents Name(s)

Parent 1 cell phone

Parent 1 e-mail

Parent 2 cell phone

Parent 2 e-mail

Teen's Cell Phone

Teen's e-mail

Check here if your child can walk home.

Do you have a special skill that you could share with our community?

I would like to make a donation towards the Youth Scholarship program?

Please select appropriate dues

Wed, May 8 2024 30 Nisan 5784