Madrichim 2024-2025

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* Student Name:

* Student Cell Phone

* Student Email:

* Emergency Contact:

Please provide a name, phone number, and relationship to teen. We will contact this person in case of emergency if a parent cannot be reached.

* Grades K-4 meet in the early session (9-11); Grades 5-7 meet in the late session (11:30-1). Please indicate your preference(s):

Early Session — Kindergarten through 4th GradeLate Session — 5th through 7th Grade (open to madrichim/ot in Grades 10-12)Both sessions — early and lateNo preference — assign me where I'm most needed

* Please indicate if you would like to be assigned to a particular grade or teacher:

We will do our best to honor requests.

* Are you open to being matched with a student to shadow or work with one-on-one over the course of the year?

Please Select OneYesNoMaybe

Is there anything else we should know?

Sat, September 7 2024
4 Elul 5784

Sat, September 7 2024 4 Elul 5784