Bar / Bat Mitzvah Twinning Program

Thank you for your interest in the JFR’s Bar/Bat Mitzvah Twinning program. Please complete the information. You will be able to make your donation immediately on the following page or you can mail a check at a later date.

Family Information

Full name of the Bar/Bat Mitzvah *

Date of Bar/Bat Mitzvah *

Parent or Guardian *

Address Line 1

Address Line 2

City

State

ZIP

Home Phone *

Cell Phone

Fax

Rescuer

Name of Rescuer you would like to be twinned with: *

To select a rescuer please view our list of rescuers.

Certificate

Please indicate the name and title of one person from your congregation who you would like to appear on the certificate (i.e., rabbi, cantor, or president):

Full Name *

Title *

Name of Congregation *

Address

City

State

ZIP