Printed fromChabadOrange.com

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JewQ

JewQ Registration Form 2024-2025

For students in grades 3-7

Scholarships available. (To request a scholarship, call the Chabad office prior to completing this form).
Child 1 Name*
First Name Last Name
Child 1 Grade*
Child 1 T-shirt Size*

Youth SYouth MYouth LYouth XLAdult SAdult M
Child 2 Name
First Name Last Name
Child 2 Grade
Child 2 T-shirt Size

Youth SYouth MYouth LYouth XLAdult SAdult M
E-mail*
Fees* Book is required together with registration. If your child already has a book from previous years, then only registration fee is necessary

Registration $75Registration $75 + Book $25Registration $75 + 2 Books $25 each (siblings)Be a JewQ Sponsor $180
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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