REGISTRATION FORM
Yes! I would like to be part of KADIMA.
Name: _________________________________________________
Address:
_______________________________________________
_______________________________________________
Home Phone:
__________________ E-mail Address:
______________
Grade in School:
_____________ Date of Birth: ________________
Mother’s Name:
__________________________________________
Address:
_______________________________________________
_______________________________________________
Home Phone:
__________________ Work/Cell Phone:
_______________
Father’s Name:
__________________________________________
Address:
_______________________________________________
_______________________________________________
Home Phone:
__________________ Work/Cell Phone:
_______________
The Reading
Chapter of Kadima is offering two dues options:
____ $18 membership for participation in all
international, regional,
and local Kadima events.
____ $10 membership for participation in all local
events only.
Please return this
completed form plus a check made payable to Kesher Zion Synagogue. Make sure to note on the check that it is for
KADIMA.
Send form and
check to: KADIMA, Kesher Zion Synagogue,