Knowledge for College Registration

January 13th 4 – 8PM at CBI and includes dinner

March 3rd 4-6PM at Temple Bat Yahm and includes snacks

April 14th 6-8PM at CBI includes snacks

$10/per event

Number of students attending March 3rd event*
Price: $10.00 Quantity:
Number of students attending April 14th event*
Price: $10.00 Quantity:
List student(s) name, email, grade, high school, and synagogue affiliation.*
Address*
Street Address City State ZIP Code
Name (Parent 1 and name on credit card)*
First Last
Email (Parent 1)*
Enter Email Confirm Email
Phone (Parent 1)*
Name (Parent 2)
First Last
Phone (Parent 2)
Email (Parent 2)
Comments (optional)
Payment Information
Total
$0.00
Payment Method*
- Charge my account on file
- I will send a check to the CBI office
- Credit Card (Visa or MasterCard)
Credit Card

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Payment Information