JRA B'nai Mitzvah Program

JRA B'nai Mitzvah Program

Thank you for your interest in completing your B'nai Mitzvah service project at JRA! Use this form to get started.
Name of B'nai Mitzvah*

First NameLast Name
B'nai Mitzvah Student Pronouns*
For more information about personal pronouns, see https://www.mypronouns.org/
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Parent/Guardian 1*

First NameLast Name
Parent/Guardian 1 Email Address*
example@example.com
Parent/Guardian 1 Phone Number*
Please enter a valid phone number.
Name of Parent/Guardian 2

First NameLast Name
Parent/Guardian 2 Email Address
example@example.com
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Have you volunteered at JRA before?*

YesNoIt's been a long time
Date of B'nai Mitzvah*

MonthDayYear
Date
Name of B'nai Mitzvah Synagogue*
Name of B'nai Mitzvah School*
T-Shirt Size (Adult sizes)*

SMLXLXXL
How will you be completing your project? B'Nai Mitzvah Projects requires 10 hours of volunteer service. Please select from this list which volunteer activities you will complete to reach 10 hours of service. (Food distributions are ~3 hours, 3 Distributions = 10 hours).*

Pack/Deliver at Food DistributionsCreate Caring CardsOrganize a food or supplies driveOther
Which Food Distributions will you be attending?*

Sunday, February 12, 2023Sunday, March 19, 2023Sunday, April 23, 2023Sunday, May 21, 2023Sunday, June 11, 2023Sunday, July 16, 2023Sunday, August 13, 2023Sunday, September 10, 2023Sunday, October 15, 2023Sunday, November 12, 2023Sunday, December 17, 2023
What area would you like to deliver in? (Choose as many as apply)

Far Northeast Philly (By the JRA Warehouse)Near Northeast Philly (Oxford Circle/Mayfair Area)North PhillyCenter CitySouth PhillyWest PhillyBucks CountyMontgomery CountyDelaware CountyThe Main LineAnywhere
Additional comments or questions?
Should be Empty: