• 2014 CAMPER APPLICATION

    Required of all 1st-time Havurah participants
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  • Summer Leadership Program for Teens from the Russian-Speaking Jewish Community

    • YJ Camp 
    • Lead Names 
    • End 
    • PART I: CAMPER INFORMATION 
    • Teen #1 
    • Basic Camper Information

      Please complete fully for prospective Havurah camper
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    • Camper's Place of Birth

    • Other Camp Info 
    • End 
    • End 
    • Teen #2 
    • Basic Camper Information

      Please complete fully for prospective Havurah camper
    •  -
    •  -
    • Camper's Place of Birth

    • Other Camp Info - Teen #2 
    • End 
    • End 
    • Teen #3 
    • Basic Camper Information

      Please complete fully for prospective Havurah camper
    •  -
    •  -
    • Camper's Place of Birth

    • Other Camp Info - Teen #3 
    • End 
    • End 
    • PART II: FAMILY INFORMATION 
    • Parent/Guardian 1

      Primary contact
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    • Parent/Guardian 1 Place of Birth

      Please indicate the birth country, city and state (if applicable) of Parent/Guardian #1 below.

    • Parent/Guardian 2

      Secondary contact
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    • Parent/Guardian 2 Place of Birth

      Please indicate the birth country, city and state (if applicable) of Parent/Guardian #2 below.

    • Family Jewish Community Involvement

      This information is necessary to confirm scholarship eligibility
    • PART III: CAMPER ESSAY 
    • Personal Response

      To be completed by each prospective Havurah camper
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    • Should be Empty: