B'nai Mitzvah: Acts of Memory (Los Angeles)

I am interested in the following B'nai Mitzvah programs (check as many as apply): *
Receiving the name of a child who perished in the Holocaust to remember Being paired with a Holocaust survivor's descendant Scheduling a private tour for my family Attending a "L'Dough V'Dough" challah-braiding session Volunteering or raising money for the Museum as a mitzvah project Registering the name of a child that I received from my synagogue or teacher:
Name of the Bar/Bat Mitzvah student: *
Preferred Gender Pronoun (e.g. he/him, she/her, they/them)
Bar/Bat Mitzvah student's email
Date of the Bar/Bat Mitzvah: *
Name and address of your synagogue or B'nai Mitzvah program: *
Congregation affiliation:
Name of the rabbi, cantor or officiant the bar/bat mitzvah student is studying with: *
Email address for rabbi, cantor or officiant:
Your contact information:
Name *
Relationship to Bar/Bat Mitzvah: *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone * - ### - ### ####
Email *
If you would like to receive a name of a child to remember, do you have any preferences? (for example, country of origin, first or last name)
Preferred gender of remembered child:

Preferred gender of remembered child: girl boy doesn't matter
How did you hear about the B'nai Mitzvah: Acts of Memory project? *
Is there anything else you would like to tell us?
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