Waiting List for Summer Machane

Section 1: Applicant's Details

Camp applying for?*

Gimmel (Yr 10) - £1250

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?*

Yes
No

Applicant's Name*

First Last

Gender*

Male
Female

Date of Birth*

School*

School Year*

Sviva

Other Sviva - Please specify

Who would you like to share a room with? (please list two friends)*

Parent/Guardian 1

Title*

Name*

First Last

Telephone (Home)*

Telephone (Mobile)*

Email*

Synagogue*

Marital Status

Parent/Guardian 2

Title

Name

First Last

Telephone (Home)

Telephone (Mobile)

Email

Synagogue

Marital Status

Waiting List for Summer Machane

Section 1: Applicant's Details

Parent/Guardian 1

Parent/Guardian 2

If you would like more information about what we do

London

Manchester

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