Skip to main content

akiva for teens

About
Registration
Scholars in Residence (SIR)
2024-25 Programs
Cleveland Shin Shinim
Past Programs
- Zikaron BaSalon for Cleveland Teens
- Witness
Search

Loading...

Editing previous response:

Please fix the highlighted areas below before submitting.

2024-25 TESTIMONY THEATER CLEVELAND REGISTRATION FORM

2024-25 TESTIMONY THEATER CLEVELAND REGISTRATION FORM

Please complete the form below. Required fields marked with an asterisk *

2024-25 TESTIMONY THEATER CLEVELAND REGISTRATION FORM

STUDENT INFORMATION

First Name*

Answer Required

Last Name*

Answer Required

Date of Birth*

Answer Required

Grade as of September 2024*

Answer Required

Student Phone*

Number Required

Student Email*

Answer Required

Student School*

Answer Required

Jewish Experience (please check these that apply)*

Answer Required

MJDS

GSDS

Fuchs Mizrachi

Synagogue School

NFTY

USY

Bnei Akiva

BBYO

NCSY

IsraelNow trip

Jewish Camp

Other:

Synagogue *

Answer Required

PARENTS INFORMATION

Parent 1 First Name*

Answer Required

Parent 1 Last Name*

Answer Required

Parent 2 First Name*

Answer Required

Parent 2 Last Name*

Answer Required

Parent 1 Phone*

Number Required

Parents 2 Phone*

Number Required

Parent 1 Email*

Answer Required

Parents 2 Email*

Answer Required

Address*

Answer Required

City*

Answer Required

State*

Answer Required

Zip Code*

Answer Required

In Case of Emergency, Person to Contact (If Not Parents)*

Answer Required

PARENT OR GUARDIAN SIGNATURE

Parent or Guardian, Print Your Name and Date*

Answer Required

Confirmation Email

Confirmation Email *

Email Required

Submitting form...

Protected by reCAPTCHA - Privacy - Terms

Please verify you are not a robot:

Please fix errors above

akiva for teens

26500 Shaker Boulevard, Cleveland Phone: (216) 367-1388 [email protected]

Footer Link

Support @akiva

@akiva For teens offers fun opportunities for cleveland teens to explore and strengthen their jewish identity and love for israel, while fostering everlasting friendships

From israel advocacy, leadership training and college prep for jewish students to original jewish theater, @akiva offers hebrew and so much more!

Powered by Edlio Edlio Login

Mobile Footer Links

Staff Directory
Calendar
News
Contact