Bnai Mitzvah Date Request Form

Bnai Mitzvah Date Request Form
Dates are filled on a first come, first served basis with your $500 deposit.

Student's Name:

* First Name

* Last Name

Email Address (if they have)

cell phone number (if they have)

* Hebrew Name

Please confirm your contact information

* Guardian 1. First Name

* Last Name

Email Address

Mobile Phone Number

Gaurdian 2. First Name

Last Name

* Email Address

* Mobile Phone Number

Selecting a Date:
Please note: B'nai Mitzvah are not scheduled for six weeks starting mid June through the end of July.

Date and Time Requested: (Please list 3 choices)

* 1. Service Time Request

* Date Request

2. Service Time Request

* Date Request

3. Service Time Request

* Date Request

* Are there any special circumstances we should be aware of?

Celebrate Your Simcha:

Social Hall Information or Reservation

Friday Night Shabbat DinnerSaturday Kiddush LunchReception / PartyI would like more information before making a decision.A $250 deposit is required to hold the space.

* Your date will be held as long as you are a member in good standing.
* The Bnai Mitzvah family must be a paying member in the fiscal year of the Bnai Mitzvah.
* Teen Tuesday: All seventh graders are required to participate in our Teen Tuesday program, which includes our teen philanthropy program, Tzedakah Teens.

A one-time Bar/Bat Mitzvah fee covers all expenses related to the service, including individualized instruction, all preparatory materials, study and rehearsals with the clergy, the Friday night Oneg Shabbat, (and challah & juice or Havdalah as appropriate), and Teen Tuesday. The total fee is $3,600. All fees must be paid in full prior to the Bnai Mitzvah.

* Your Bar/Bat Mitzvah deposit of $500, to secure your date will be deducted from your Bnai Mitzvah Fee.

Your Bar/Bat Mitzvah deposit of $500, to secure your date will be deducted from your Bnai Mitzvah Fee.

I understand that I will be charged the non-refundable deposit, for this initial fee, upon confirmation of my Bar/Bat Mitzvah date.

Bnai Mitzvah Fee Balance Due: $3,100 (after $500 deposit is received):
The balance of the Bnai Mitzvah fees may be made in monthly payments with the final payment due 3 months before the Bnai Mitzvah, or due in 3 installments; 1 year prior, 6 months prior and 3 months prior to the Bnai Mitzvah. These payments will automatically be charged to the credit card on file at the time they are due.

Please charge my credit card for the balance due after my deposit.Please charge my credit card monthly (charges will start the month after this form is received.)Please charge my credit card in the 3 installments listed above.I would like to arrange different payment options. Please call me.

We look forward to sharing in your simcha!

Please call Jessica Dishell at 818-348-0670 ext. 200 with any questions.

Wed, December 6 2023 23 Kislev 5784

Bnai Mitzvah Date Request Form

Celebrate Your Simcha:

Kol Tikvah is a member of the Union for Reform Judaism and opens its doors to families of all types - Traditional, LGBTQ, Interfaith, and Dual Faith.