Kadima Membership Form – Highland Park Conservative Temple

Kadimanick Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Kadimanick Email

Home Phone *

Kadimanick Cell Phone

Grade *

Birthdate *//

School *

Do you want to register a second Kadimanick? *

Yes
No

Name *

First

Last

Kadimanick Email

Kadimanick Cell Phone

Grade *

Birthdate *//

School *

Parent Information

Parent 1 Name *

First

Last

Parent 1 Cell Phone *

Parent 1 Email *

Parent 2 Name

First

Last

Parent 2 Cell Phone

Parent 2 Email

HPCT-CAE B'nai Mitzvah Gift

Please check here if you will be using the free year awarded by HPCT-CAE for your Bar or Bat Mitzvah. You may scan and upload the certificate below, or bring it into the Temple Office.

HPCT-CAE B'nai Mitzvah Gift – 2nd Child

Please check here if you will be using the free year awarded by HPCT-CAE for your childrens B’nai Mitzvah for both children. You must check both boxes to show the discount below. You may scan and upload the certificates below, or bring them into the Temple Office.

Please scan your B'nai Mitzvah certificate and upload it here

Click or drag a file to this area to upload.

Please scan your B'nai Mitzvah certificate and upload it here

Click or drag a file to this area to upload.

Kadima membership dues 2021-2022 *

Price: $ 45.00

Kadima membership dues 2021-2022 *

Price: $ 90.00

After clicking Submit you will be taken to PayPal where you can enter your credit card information. You do not need a PayPal account, but you can log in to use your account if you have one.

Total

$ 0.00