4817 St Charles Pierrefonds, QC H9H 3C7
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About You

About You

Tell us about you!

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We are a Community Center - 'where everyone is family'. Let us know about the people and dates that important in Your life, so we can be able to best serve you.

Family Information Form

Husband Information

Full Name

Hebrew Name

Home Phone

Cell

Email

Address

City

Zip Code

English Birthday

After night fall

Hebrew Birthday

We will fill it out, unless you would like to Click here for your Hebrew Birthday

Profession

Wife Information

Full Name

Hebrew Name

Email

Cell

Anniversary

English Birthday

After night fall

Hebrew Birthday

We will fill it out, unless you would like to Click here for your Hebrew Birthday

Profession



Child Information

Full Name

Hebrew Name

English Birthday

After night fall

Hebrew Birthday

We will fill it out, unless you would like to
Click here for your Hebrew Birthday

Full Name

Hebrew Name

English Birthday

After night fall

Hebrew Birthday

We will fill it out, unless you would like to Click here for your Hebrew Birthday

Full Name

Hebrew Name

English Birthday

After night fall

Hebrew Birthday

We will fill it out, unless you would like to
Click here for your Hebrew Birthday

For additional children, please use this box to fill in the above mentioned information.

Yartzeit Information

Full Name

Hebrew Name
Relationship

English Date

After night fall

Hebrew Date

We will fill it out, unless you would like to
Click here for your Hebrew
Date

Full Name

Hebrew Name
Relationship:

English Date

After night fall

Hebrew Date

We will fill it out, unless you would like to
Click here for your Hebrew
Date

We will fill it out, unless you would like to
Click here for your Hebrew
Date
Full Name Hebrew Name
Relationship:
English Date

After night fall

Hebrew Date

Full Name

HebrewName
Relationship:


English Date

After night fall

Hebrew Date

We will fill it out, unless you would like to
Click here for your Hebrew
Date

Programs that would interest me

Daily Minyan

Holiday Events

Shabbat Services

Kids Programming

Challah baking

Adult Education & classes

Community Shabbat Dinners

Hebrew School

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