Child's name *

First Name

Last Name

Gender *

Male

Female

Date of birth *

MM

DD

YYYY

Preferred date for ceremony

MM

DD

YYYY

Father's Name *

First Name

Last Name

Are both of father's parents Jewish? *

Yes

No - only Mother

No - only Father

No - Neither

Mother's name *

First Name

Last Name

Are both of mother's parents Jewish? *

Yes

No - only Mother

No - only Father

No - Neither

Are there any adoptions or conversions in the family? *

Yes

No

I have a document proving Jewish identity *

Proof of child's Jewish identity is required before a Bar/Bat Mitzvah ceremony. Examples of documents: the Ketubah of the child's parents, maternal grandparents, or a conversion certificate on the maternal side. Please let us know whether or not you have any documents, and if yes, please email them after completing this form.

Yes, I will email a copy of a document to Rabbi@Jewishbattersea.com

No, please contact me to discuss other options of verification

Preferred contact *

Father

Mother

Phone *

Country

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country