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Adult Education Women's Rosh Chodesh Society

RCS Registration Form

Full Name*
First Name Last Name
E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*

Area Code Phone Number
Registration fee (includes student's manual)*

Sponsor: $180Regular: $120Scholarship: to apply for a full or partial scholarship, contact Yael directly
Total

$0.00

Payment*

Credit Card Zelle

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