EmailMe Form - J-LEAD 2018-2019 Application

Name *

First Last

Email *

Cell Phone *

### - ### - ####

Home Phone

### - ### - ####

Home Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Parent/ Guardian 1 Name *

First Last

Parent/ Guardian 1 Email *

Parent/ Guardian 1 Cell Phone *

### - ### - ####

Parent/ Guardian 2 Name

First Last

Parent/ Guardian 2 Email

Parent/ Guardian 2 Phone

### - ### - ####

Date of Birth *

MM / DD / YYYY

Age *

Grade *

School *

JCC Member? *

Yes

No

Affiliated with a synagogue? *

Yes

No

If affiliated with a synagogue, which one?

Are you involved in any youth groups? *

Yes

No

If involved in a youth group, which one?

How did you hear about J-LEAD?

Why I Want to be a Leader

Essay Question: In 250-500 words, please answer the following questions and upload a Word or PDF Document.

1. Why do you want to participate in J-LEAD?
2. What part of the program is most appealing to you?
3. Where will you use the skills you learn in J-LEAD?
4. What Jewish value do you think is the most important for a leader to uphold and why? *

A recommendation letter from a youth group leader, teacher, coach, clergy member, etc. describing why you will make a strong leader. This person may not be related to you.

This may be submitted electronically with your application, or mailed to:
Sara Sideman
Katz JCC
1301 Springdale Road
Cherry Hill, NJ 08003