MJCBY Contact Info

Question Title

* 1. Family Member 1

Name

Date of Birth

Address

City

State

Zip code

Hebrew Name

Cell Phone Number

Home Phone Number

Question Title

* 2. Family Member 2

Name

Date of Birth

Hebrew Name

Cell Phone

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* 3. Child 1

Name

Date of Birth

Hebrew Name

Cell Phone

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* 4. Child 2

Name

Date of Birth

Hebrew Name

Cell Phone

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* 5. Child 3

Name

Date of Birth

Hebrew Name

Cell Phone

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* 6. Child 4

Name

Date of Birth

Hebrew Name

Cell Phone

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* 7. Child 5

Name

Date of Birth

Hebrew Name

Cell Phone

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* 8. Preferred Method of Contact (Check all that apply)

Text

USPS Mail

Phone Call to Cell

Phone Call to Home

Question Title

* 9. Do you receive MJCBY weekly eblasts?

Yes

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* 10. Do you have Internet access through a computer or Ipad?

Yes

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* 11. Do you receive phone updates from MJCBY?

Yes

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* 12. How would you like to receive your monthly newsletter?

Electronically only

Paper Copy