Today is July 20, 2019 /

Post B’nai Mitzvah

Post B'nai Mitzvah

Thank you for registering your teen in Jew Crew. We look forward to seeing them in the fall.

Please do not hesitate to contact our treasurer at treasurer@uvjc.org for special abatements or scholarships if you are in financial need. The UVJC does not turn anyone away for financial reasons.
Name*
First Last Hebrew
Date of birth*
Date Format: MM slash DD slash YYYY
Gender*
Education information*
Please describe your teen's learning style and provide any tips you have to help the teacher succeed in working with them.
Physician's Name*
Physician's Phone Number*
Allergies/Special Health Considerations*
Medication authorization
- I authorize the UVJC to administer medications that I have supplied for medical conditions noted above. I have supplied the following medications to the Director of Education, and instructions are attached to the medications supplied.
Photo authorization
Please indicate below whether you give permission for your teen’s first name(s) and/or photograph(s) or video(s) to be used on the UVJC website, in school newsletters, in congregational newsletters, and on weekly email updates.
Mitzvah opportunities*
Please check the mitzvot you would like to undertake this year:
- host the Jew Crew families for a pot-luck havurah (1-2 hour shabbat or havdallah meal / candle lighting / social gathering)
- drive Jew Crew members on a local field trip (typically nursing home or food pantry)
- substitute teach Hebrew school when Dartmouth students are on break (lesson plans provided!)
- tutor students one-on-one in Hebrew once a month for 30 minutes
- host a Dartmouth Hillel student for shabbat or a holiday meal
- make latkes (at the Roth Center) for Hannukah
- bake treats for Purim
- lead a workshop or activity at the Congregational Retreat at Hulbert (Dec 13-14)
- sorry but I can't do any of these
- other: please email school@uvjc.org because I can't figure out how to add a text box here
Tuition*
Parent/Guardian 1 Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone (primary)*
Phone (secondary)*
Email*
Parent/Guardian 2 Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone (primary)*
Phone (secondary)*
Email*
Health insurance company*
Insurance policy number*
Insurance company contact information*
Alternative Emergency Contact (Primary)
Name*
First Last
Address*
City State
Phone (primary)*
Phone (secondary)*
Payment Information
You will be sent an invoice via email. Please direct any questions to Chris DePierro by email at office@uvjc.org or by phone at (603) 646-0460.
Total
$0.00

Upper Valley Jewish Community
5 Occom Ridge, Hanover, NH 03755
603-646-0460 | office@uvjc.org

Post B’nai Mitzvah

Post B'nai Mitzvah

Parent/Guardian 1 Information

Parent/Guardian 2 Information

Alternative Emergency Contact (Primary)

Payment Information