Lakewood Weekend Retreat
Male students and young professionals, aged 19-30, are invited to join our annual Lakewood Mentors Mission Shabbaton and be part of the worldwide Shabbos Project experience!

Spaces are limited for this exciting weekend!  At previous Weekend Retreats, we have been forced to close off registration due to high demand, so make sure to register while there is still space!

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Email *
First Name *
Last Name *
email *
Cell *
Date of Birth *
How did you hear about the program (If you heard about it from friends or educators, please include their name/s)? *
If you know other students hoping to attend the program and would like to share a room with them, please share their names and contact information here. *
Contact Information
Your Current Address *
Address 2
City *
State *
Postal Code *
Educational Information
What university do you attend, or have most recently attended? *
Did you graduate from university? *
What is your area of study/current profession? *
Jewish Background
Father's Religion *
Mother's Religion *
Self Religion *
Please list any Jewish schools, camps or youth groups that you have participated in? *
Have you been on any trips to Israel before (If yes, please include the names of each trip)? *
Special Requirements
If you have any allergies (food, pet, etc), please list them here:
Do you currently have, or did you have in the past, any special health needs that we should be aware of? *
Please describe if applicable, otherwise: write "none"
Are you currently taking any medication or receiving psychological counseling? *
Please describe if applicable, otherwise: write "none"
Personal Statement
General Information
Describe why you are interested in attending the Lakewood Weekend Retreat (2-3 sentences): *
Thank you for taking the time to complete this application.
Make sure you click the submit button below!!!
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