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Shalom Families Interest Form

Name*
First Last
Email*
Spouse/Partner Name
First Last
Phone
Zip Code*
ZIP Code
Child's/Children's name(s) and age(s)*
Which events would you most likely attend?*
- Select All
- Holiday Celebrations
- Parents-Only Events
- Shabbat/Havdalah Programs
- Play Groups
- Educational Programs/Discussions
- Other
Would you be interested in hosting/helping to plan an event?*
- Yes
- No
- Maybe
The make up of your family is:
- All members are Jewish
- Interfaith household (Jewish and other religion/cultural background)
- Family is not Jewish
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