Registration Form - Israeli Families October 2023

Registration Form - Israeli Families

October 2023
When did you arrive in the United Kingdom?*

MonthDayYear
Date
Where are you staying in the UK?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
This form is to gather information to help us support Israeli children who have come to the UK as a result of the war in Israel. Please complete this form to help us develop the support we can provide. This support may include a place in a Jewish school (temporary or permanent).
I would to express an interest in a placement for my child in a Jewish school*

YesNo
We also have a kaytana (day camp) on offer for Israeli child who have come to the UK as a result of the war in Israel. This will be running during the UK school half-term (October 23-27).
I would like to apply to be included in the kaytana (day camp):*

YesNo
Advert Flyer for the Kaytana (day camp)-פלייר פרסום עבור הקייטנה
Manchester: We may also offer informal activities on weekends in Manchester.
I would like to express an interest in joining activities in Manchester on the weekend (Friday or Sunday).*

YesNo
Information About Your Child
Name*

First NameMiddle NameLast Name
Preferred Name*
Date of Birth*

MonthDayYear
Date
Please upload a legible photograph or scan of the passport of your child*

Cancelof
Address in Israel*

House Number or Name

Street Address Line 1

CityBorough

Post CodeCountry
What type of school did your child attend in Israel?*
School Year in Israel*
I would like to add details for an additional child.

YesNo
Name (2nd Child)

First NameMiddle NameLast Name
Preferred Name (2nd Child)
Date of Birth (2nd Child)

MonthDayYear
Date
Please upload a legible photograph or scan of the passport of your child (2nd Child)

Cancelof
Address in Israel (2nd Child)

House Number or Name

Street Address Line 1

CityBorough

Post CodeCountry
What type of school did your child attend in Israel? (2nd Child)
School Year in Israel (2nd Child)

Primary Contact Information
Primary Contact Information

This will be the first person we contact in the case of an emergency and will have authority to take the child home from school at any time.
Name*

TitleFirst NameLast Name
Relationship to Child*
Address*

Same as ChildOther
Address in Israel*

House Number or Name

Street Address Line 1

CityBorough

Post CodeCountry
Home Phone Number
Mobile Phone Number*
Work Phone Number
Email*
example@example.com

Secondary Contact Information
Secondary Contact Information

This will be the second person we contact incase of an emergency and will have authority to take the child home from school at any time.
Name

TitleFirst NameLast Name
Relationship to Child
Address

Same as ChildOther
Address in Israel

House Number or Name

Street Address Line 1

CityBorough

Post CodeCountry
Home Phone Number
Mobile Phone Number
Work Phone Number
Email
example@example.com

Language and Learning
What is your child's first language?*
What is your child's level of spoken English*

NoneThey can speak a few words in EnglishThey are a confident English speakerOther
Does your child speak a second language?*

NoYes
Does your child have any learning or support needs that we should be aware of? For example ADHD, Autism, Dyslexia*

Other Information
Please use this box to tell us any other information about your child or your family*
Agreement

Thank you for taking time to complete this form. By submitting this form you agree to UJIA storing, sharing and using this data about your child and your family for all reasons related to their placement at a UK school or participation in a Kaytana (day camp) or other informal education activities.
"I agree"*

YesNo
Should be Empty:

	Allergic	Intolerant	Not Applicable
Celery
Cereals containing gluten
Eggs
Fish
Lupin
Milk
Mustard
Peanuts
Sesame
Soybeans
Tree nuts

	Yes	No
Around the school & in classrooms
On our website and in our prospectus
On UJIA and partner organisations own social media
In external media (e.g. newspapers)

	Yes	No
Around the school & in classrooms
On our website and in our prospectus
On UJIA and partner organisations own social media
In external media (e.g. newspapers)

Registration Form - Israeli Families

This form is to gather information to help us support Israeli children who have come to the UK as a result of the war in Israel. Please complete this form to help us develop the support we can provide. This support may include a place in a Jewish school (temporary or permanent).

We also have a kaytana (day camp) on offer for Israeli child who have come to the UK as a result of the war in Israel. This will be running during the UK school half-term (October 23-27).

Manchester: We may also offer informal activities on weekends in Manchester.

Information About Your Child

Primary Contact Information

Secondary Contact Information

Medical and Dietary Information

Language and Learning

Sharing Information

Permissions for Images and Videos

Other Information

Agreement