Family Application

Name(s)

Address

Phone Number

E-mail

Occupation(s) (optional, but helpful for making good matches)

Do you have kids? If so, what are there names/ages/genders?

Do you have pets? If so, what kind of pets?

What is your level of Jewish observance? Reform Conservative Orthodox Other (please explain) Synagogue Affiliation: Do you keep kosher?

Do you have a gender preference for your student? Male Female Doesn't matter

Would you be okay with picking up your student in Oakland? Yes No

Are you willing to be matched with more than one student, as some students prefer to come with a friend? Yes No

Which activities are you most interested in doing with your student? Mostly Jewish Secular Both

Please write a few sentences about your interest in and expectations for this program.

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