Interest Form for the Fall 2024 Cohort of the URJ Teen Israel Organizing Immersive

Confirmation Email Sender (Org-Wide Email Display Name)

Confirmation Email Subject

Confirmation Email Body

For more information about the URJ Teen Israel Organizing Immersive, or to speak with director Bryan Oren, please fill in your contact details below.

If you haven't already done so, please be sure to look at the URJ Teen Israel Organizing Immersive website.

Your First Name

Your Last Name

Your Email

Please choose one of the following options.

I am a participant 18 years of age interested for myself.I am a legal guardian/custodial parent interested for a teen dependent.I am under 18 years of age interested for myself.

Your Birthday

Parent/Guardian's First Name

Parent/Guardian's Last Name

Parent/Guardian's Email Address

Participant's Birthday

Participant's First Name

Participant's Last Name

Participant's Email Address

By submitting this form, you authorize future communications via mail, email, text and phone for the purposes of transactional communications as well as marketing communications for this and other URJ programs. Please know that we do not sell or market email addresses. If you do not wish to receive further communications from the URJ and URJ affiliates you will be able to opt out at the time of receipt.