Havurah Application
Please fill out this form if you would like to join a Havurah. A Havurah coordinator will be in touch with you shortly. For more information, please contact Bobi Levine, Havurah Chair, at (408) 446-1128 or
bobilou5@gmail.com
.
* Required
Adult #1 Name
*
Your answer
Age
Your answer
Email Address
*
Your answer
Phone number
*
Your answer
Adult #2 Name
Your answer
Age
Your answer
Email Address
Your answer
Phone number
Your answer
Address
Your answer
City
Your answer
Zip Code
Your answer
Children's names, ages, and gender, if any:
Your answer
Would you prefer a Havurah consisting of:
Adult group similar to your age
Children the same age as your children
Singles
Mixed ages
Single parents
No preference
Are you primarily interested in:
Activities for adults
Activities for adults & children
From the following list of suggested programs, please rank your level of interest from 1-10
1
2
3
4
5
6
7
8
9
10
Attend local cultural events
Create an "extended family"
Social action and discussion
Temple involvement
Nature
Attend sporting events
Expand Jewish knowledge
Celebrate Jewish holidays
Day trips to Bay Area points of interest
1
2
3
4
5
6
7
8
9
10
Attend local cultural events
Create an "extended family"
Social action and discussion
Temple involvement
Nature
Attend sporting events
Expand Jewish knowledge
Celebrate Jewish holidays
Day trips to Bay Area points of interest
Clear selection
Please describe your special interests, talents, hobbies, etc.
Your answer
Is there anything else about you that would help us place you in a Havurah which will meet your needs and interests? Please describe and be specific:
Your answer
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