Pre-Registration Form

Positive Jewish Parenting
Community-Wide Conference
ASHAR – 70 Highview Rd. Monsey, NY

Motzai Shabbat, November 2, 2002

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Name(s):


Mailing Address:

City, State, Zip Code:

Work Phone:

Home Phone


E-mail:

Fax

Family Synagogue:


Schools Children attend and ages of children:

Registration Fee $18.00 Per Individual in advance; $25.00 at the door

Number of Registrants:


Credit Card

Card Number

Expiration Date


Amount:

  

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