Application

*(denotes required field)

First Name:*

Middle Name:

Last Name:*

Subject:*

Select Day Camper, Session 1: 7/3-7/23 Day Camper, Session 2: 7/24-8/13 Day Camper, Both Sessions: 7/3-8/13 Dorm Program, Session 1: 7/3-7/23 Dorm Program, Session 2: 7/24-8/13 Dorm Program, Both Sessions: 7/3-8/13 Staff Application

Date of Birth:*

Parents' Names:*

Street Address:*

City:*

State:*

Zip:*

Day Phone:*

Night Phone:*

Cell Phone:*

Parent's Email:*

Camper's Email (optional):

School and Grade Attending Fall 2012:*

Name and Phone Number of School Principal:*

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Do you play a musical instrument? If so, what and for how long?*

Have you studied dance or voice? Please describe.*

Did you see "A Light for Greytowers", "The Heart that Sings" or the Camp Bnos Yisrael series?*

How did you hear about Kol Neshama?*

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Why do you want to attend this summer?*

Anything else you'd like to tell us? (optional)

I need to schedule an interview with the Kol Neshama staff:

I ALREADY had an interview with Robin Garbose or a KN staff member:

If you have any files to attach (letters of recommendation, a photo, etc.), do so here.

Acceptable file types: doc,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 1mb.

Your daughter cannot be enrolled until the Tznius Contract below is printed, signed and mailed to us with your deposit.

I have read the Tznius Contract and agree to its terms.

Tznius Contract

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