Register Interest

Expression of Interest Regarding: Camp Distance Education

Name of Student:
State School 2009:
Grade (year level) 2009:
Date of Birth:
Name of Parents:
Address:
Postcode:
Phone (home):
Phone (work/mobile):
Email:

Student Knowledge of Hebrew language (only required for UJEB Camp enquiries):

Has he/she attended a Jewish day school, Hebrew centres or after school program previously?
Yes No
If yes, which school:
Until year:

I wish to be: Called Emailed