Application Form for "Reaching for the Stars"

If you would like more information or need help with your application, please contact us.

Applicant Information
First Name:
Last Name:
Email:
Birthdate:
Address:
City:
State:
ZIP Code:
Home Phone:
High School:
Year:
Synagogue Affiliaton:
 
Personal Statement and Activities
List your extracurricular interests and describe your involvement:
Please include clubs, sports, leadership roles, Jewish/Israel activities, and any after-school or weekend activities.
 
Why do you want to be on Reaching for the Stars?
Suggested points to include (please respond in 250 words or less):
  • What do you hope to gain from your participation in the program?
  • What will you bring to the program?
  • What does Jewish Heroism mean to you?