Israel Tour Initial Interest 5780

RSY-Netzer Israel Experience interest form 2021/5781

July 2021 (all dates contingent on the changing situation with COVID-19) This form will put you on our database so we can provide you with updates regarding Israel experiences.
Please note filling out this form does not guarantee you a place on an Israel experience in 2021.

If the participant has not attended an RSY-Netzer event before please fill in the entire form. If the participant has previously attended an event then you only need to fill in the compulsory sections.
What school year group is the participant in? *

Year 11 Year 12
Has the participant previously attended an RSY-Netzer event? *

Yes No
Parent Full Name *
Email Address *
Child's Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Synagogue
School Name
Should be Empty:

RSY-Netzer Israel Experience interest form 2021/5781