APPLICATION FOR ATTESTATION OF JEWISH DESCENT

Name:

Address:

City:

Province:

Postal code:

Phone number:

Fax:

Email:

Cell phone:

Date of Birth:

Father's name:

Mother's name:

Mother's Maiden name:

Date of Aliya:

Signed:

Date:

APPLICANT’S BIRTH CERTIFICATE AND PASSPORT ARE REQUIRED. IF AVAILABLE, A COPY OF PARENT’S BIRTH CERTIFICATE AND KETUBA IS REQUESTED.

PLEASE ATTACH TWO LETTERS FROM TWO RABBIS ATTESTING TO THE APPLICANT’S JEWISHNESS AND IF REQUIRED CELIBACY.

A fee of $100.00 (cash or charge) will apply.

Credit Card #: Expiry Date: