Shefa 2016-2017 Registration
First Name
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Last Name
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Home Address
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Phone
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Email
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Parent/Guardian #1 Name
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Parent/Guardian #1 Phone
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Parent/Guardian #1 Email
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Parent/Guardian #2 Name
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Parent/Guardian #2 Phone
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Parent/Guardian #2 Email
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Student lives with?
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Current school
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Current grade
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How did you hear about Shefa?
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What interests you about Shefa?
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What experiences, if any, do you have with gardening, agriculture and/or issues of food justice? (No background required, we are just curious)
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Is your family part of CBI, Beit Ahavah, JCA or any other Jewish community? (Again, not required, just curious)
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Anything else you would like to let us know?
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