Camp Nageela Video
Home
Programs
Photo Gallery
Guestbook
Nageela
Donations
 



 


THE SURI SCHWARTZ
JEWISH INDIVIDUALIZED LEARNING PROGRAM - JIL


Online - Registration Form
*Mandatory Field
*First Name:
*Last Name:
*Date of Birth:
*Grade:
JIL Location:
*Address:
*City:
State:
*Home Phone:
Cell Phone:
*School:
E-mail:
Mother’s Name:
E-mail
Work Phone:
Cell Phone
Father’s Name:
Email
Work Phone:
Cell Phone
Preferred Contact Number:
*Emergency #:
 
Any other friends who may be interested in JIL:  
How did you hear about JIL?  
What do you hope to gain from JIL?  
Are you interested in help for your Bar/Bas Mitzvah?