Teen Social Justice Journey to Los Angeles Waitlist

Teen Social Justice Journey to Los Angeles Interest

"*" indicates required fields

Name*

First Last

Birthdate*

Grade entering in Fall 2025*

Which school will you attend in Fall 2025?

Do you attend part-time Jewish education?

Yes

Name of part-time Jewish school program*

Do you/your family belong to a local synagogue?

Yes

Name of synagogue*

Other Program Name*

Teen's Email*

Parent or Legal Guardian's Email*

Teen's Cell Phone*

Parent's Phone*

This field is for validation purposes and should be left unchanged.