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Chuppah v’Kiddushin Course Application
Full Name – English:
Full name – Hebrew:
Father's full name – Hebrew:
Birthdate (include year):
Address (include city, state, zip, country):
Family Status (single, married, etc.):
Tell us a little about yourself:
Describe your level of Jewish education:
How Well Can You Read and Translate Shulchan Aruch?
Not at all
Name of reference (rabbi who can vouch for your character and religious observance):
Reference phone number:
Relationship to reference:
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