Beit Lev Registration Form (School Year 2011-2012)
Parent(s) Names:______________________________________________________
Child’s Name (first and last) ___________________________________________
Age _______ Grade as of Fall 2011 ______ School _____________________
Child’s Name (first and last) ___________________________________________
Age _______ Grade as of Fall 2011 ______ School _____________________
Child’s Name (first and last) __________________________________________
Age _______ Grade as of Fall 2011 ______ School _____________________
Total Contribution: $ _________________
Best way to contact you regarding Beit Lev (email, phone, eg.)
____________________________________
Please return ASAP:
By email to: By mail to:
Liz Baker Kol HaLev
KHL Secretary and Attn: Beit Lev Program
Chair, Family Programming & 6200 N. Charles St.
Education Committee Box 102
lizb1125@mac.com Baltimore, MD 21212
Questions, Comments or Willing to Volunteer?
Please contact Liz Baker (lizb1125@mac.com) or
Susannah Wolf (susannah@gauck.com)