Course Request Form - Personal Information:
Name of Student: *
Student's Email: *
Parent/Guardian's Name: *
Parent/Guardian's Email: *
Parent's Phone Number: *
Current School: *
Grade: *
I am interested in registering for: *
Please provide a specific course name. You can refer to the Bonim B'Yachad course catalog (https://www.bonimbyachad.org/coursecatalog) *
Do you have a curriculum and text for this course, or do you want Bonim B'Yachad to supply the learning materials? *
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