AREYVUT BNAI MITZVAH INTAKE FORM
		Personal Information   Please note that all fields marked with an * are required fields   * Name:   * Parent(s) Name(s):   * Address: * City: * State: * Zip: * Phone: * Email: School Grade Date of Birth * Date of Bar/Bat Mitzvah Parsha (Torah Portion) About You... * What do you enjoy doing? What after-school or extracurricular activities do you do? What are your strengths/skills? * Below is a list of hobbies/interests. Check the 3 that interest you the most. Art Bike Riding Cooking Hanging out with friends Hiking Internet Knitting Movies Music Playing games Reading Shopping Sports Television Traveling Video Games Other:   * Below is a list of topics Check the 3 that interest you the most. Animals Anti-Semitism Children Education Environment Healthcare/Medicine Homelessness Hunger Israel Jewish Education Literacy People with Disabilities Poverty Senior Citizens Other:   About Your Mitzvah Project... Why do you want to do a mitzvah project? * If you can change anything about Judaism and/or the world what would it be? Why? What volunteer/ community service tasks have you done? What did you like about them? What didn’t you like about them? Who do you know who can help you with this project/cause? What days and times are you available to volunteer and/or work on your project?