Madrichim 2024-2025

* 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?

Thu, October 16 2025
24 Tishrei 5786

Thu, October 16 2025 24 Tishrei 5786

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