Name
*
First
Last
Student's Email
*
High School
*
Grade
*
For the
2014-2015
academic year
Please enter a number from
9
to
12
.
Home Phone
*
Cell Phone
*
City
*
State / Province
*
Parent's Email
*
How did you hear about TJJ?
*
Do you have any friends considering TJJ?
*
Yes
No
Friend's Name
*
First
Last
Which TJJ trip are they considering?
*
TJJ
TJJ Ambassadors
TJJ Ambassadors Poland
Are you a Jewish teen in public high school or a secular private high school?
*
The Jerusalem Journey trip requires you to be Jewish and that you are attending a public high school or a secular private school.
Yes, I'm a Jewish teen in public high school or a secular private high school.
Email
This field is for validation purposes and should be left unchanged.