Madrichim 2025-2026

* 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 and why:

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?

Sun, February 15 2026
28 Sh'vat 5786

Sun, February 15 2026 28 Sh'vat 5786

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