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JewQ Program and Registration

Child's Info
Child's name*

First Name Last Name
Date of Birth*

Month Day Year
Name of Child's School*
If your child has (or currently is) attended a Jewish Studies program, Please supply name of program and institution*
Parent's Info
Parent's Full Name*

First Name Last Name
Parents E-mail*
Parents Mobile Number*
Do we have permission to contact your child for the sole purpose of JEW Q?*
Participation Fee(s)
There is a suggested donation of $18 per child to cover the registration costs. For those joining for the first time, you will be required to purchase a book to the value of $40. If you have a book from previous years, there is no need to purchase another book.
Please choose the number of participation fees you would like to donate (e.g. 1 x child = $18)

$18 $36 $54 $72
Please choose the number of books you are ordering (e.g. 1 x book = $40)

$40 $80 $120 $160
T-Shirt Size*

Youth S Youth M Youth L Adult S Adult M Adult L
Total Charge

$0.00

Payment

Credit Card Paypal

Postal / Zip Code

Country

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