J-Serve 2017 Local Project Registration Page – REQUEST FORM

Please complete all three steps included below and return your form back to Aaron Watts () and Rae Williams () for processing. Thanks!

STEP 1: General Information

Please fill in your local J-Serve project information below.

  • Community to be listed in the URL (example: jserve.org/2017projectregistration/baltimore; we just need to know what you want to include in the highlighted piece):
  • About J-Serve Program Intro: (example: ‘join us on Sunday, April 2nd as Jewish teens from across the INSERT NAME community join others in service around the world by having fun while doing good’)
  • Venue name:
  • Venue address:
  • Date:
  • Time:
  • Registration Cost:
  • Number of participants at which you would like to cap your registration at (if unlimited, write ‘N/A’):
  • List of partners you would like to be shown on bottom of page (please include all partner logo files along with your completed form upon submission):
  • Any additional information you need to be visible (ie. Do adults need to be able to register?):

STEP 2: Confirmation Email Language

The below confirmation message will be auto-sent to any teen who registers for your J-Serve project. Please fill in the highlighted sections below, and make any other necessary text edits as you would like this note to read:

Thank you for registering to attend the INSERT LOCAL PROJECT TITLE J-Serve program happening on INSERT DATE at INSERT LOCATION. We are so excited you’ll be joining us and can’t wait to see you there!

Please note that our event will startat INSERT START TIME, and you should plan to be picked up by INSERT END TIME.

Special thanks again to all our partners who are helping to make this event possible, including: LIST PARTNERS HERE.

Have other Jewish friends who love service and/or need service hours toward graduation? Encourage them to register today so they can join us in being a part of expanding our overall Jewish teen service footprint for J-Serve 2017!

If you have any questions, reach out to INSERT NAME at INSERT NUMBER and/or EMAIL ADDRESS.

See you soon,

(INSERT TEEN COORDINATOR NAMES AND ‘TITLES’)

STEP 3: Registration Fields Confirmation

The following information will be collected for each individual teen registering for your program. Please add any additional fields you would like to beincluded in your form at the bottom of this list (in red).

  • Teen name (first and last):
  • Email:
  • Address (Line 1, Line 2, City, State, Zip):
  • Cell number:
  • School name:
  • Graduation year (dropdown options: 2017 - Senior; 2018 - Junior; 2019 - Sophomore; 2020 - Freshman; 2021 – 8th Grade; 2022 – 7th Grade; 2023 – 6th Grade):
  • Gender (dropdown options: M; F; I do not identify with either):
  • Parent name:
  • Parent phone:
  • Parent email:
  • If you attend a Jewish camp during the summer, please include the camp name here:
  • Are you a member of any of the following Jewish youth movements? Please select all that apply (multiple check dropdown options: NFTY; USY; NCSY; Other (Please Specify)):
  • [Other/Additional Field 1] > ______
  • [Other/Additional Field 2] > ______
  • [Other/Additional Field 3] > ______