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Summer Machane 5785 Wait list
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Section 1: Applicant's Details
Camp applying for?
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Bet Chalutzi (Year 9)
You do not need to pay anything on this form. This is a form for the waiting list. Once your application has been received we will let you know if a space opens up.
Is this the applicant’s first time at Bnei Akiva Machane?
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Yes
No
Applicant's Name
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First
Last
Gender
*
Male
Female
Date of Birth
*
DD slash MM slash YYYY
School Year
*
3
4
5
6
7
8
9
10
Parent/Guardian 1
Title
*
Mr
Mrs
Miss
Dr
Rabbi
Other
Name
*
First
Last
Telephone (Mobile)
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Email
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Name
This field is for validation purposes and should be left unchanged.
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