Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Name of Child 1*Birthdate of Child 1* MM slash DD slash YYYY Current School of Child 1*Name of Child 2Birthdate of Child 2 MM slash DD slash YYYY Current School of Child 2Name of Child 3Birthdate of Child 3 MM slash DD slash YYYY Current School of Child 3Which date would you like to attend? December 4, 2024-- 9-10:30 a.m. December 4, 2024-- 11 a.m.-12:30 p.m. December 9, 2024-- 9-10:30 a.m. December 13, 2024-- 1-2:30 p.m. December 17, 2024-- 11 a.m.-12:30 p.m. How did you hear about our Open School Days?* Postcard in the mail Postcard from pre-school Facebook Instagram A friend Email The Jewish Light My children go to school at Mirowitz Niche.com Referral Other Please describe:
