Waiting List for Summer Machane

Section 1: Applicant's Details

Camp applying for?*

Machane Ari (Year 3-5)
Aleph Chalutzi (Year 7)
Bet Base (Year 8)
Bet Chalutzi (Year 9)
Gimmel (Year 10)
Seenai Machane (Year 11)

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

Please list two friends you would like to be in a group/share a room with?*

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

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London

Manchester

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