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JSC Club Form
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
School
*
Your answer
Grade
*
9
10
11
12
Email Address
*
Your answer
Cell Phone
*
Your answer
Gender
*
Your answer
Your Preferred Pronous
Your answer
Birthday (include year of birth)
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Parent/Guardian Name
*
Your answer
Parent/Guardian Email
*
Your answer
Parent/Guardian Cell Phone
*
Your answer
Which of the following best describes you?
*
I'm Jewish
I'm Jewish culturally but not religiously
Sometimes I think of myeslf as Jewish, sometimes not
I'm not Jewish
What are you interested in? Check all that apply.
*
Israel trips
School break travel opportunities
Jewish education
Social justice
Philanthropy
Hebrew language
Isarel education (culture/history)
Israel advocacy (politics)
Shabbat and holiday opportunities
Fitness/sports
Social/hangout programs
College or career prep
College scholarships
Scholarships for Jewish programs
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