Little PAL Form

Little PAL

*Please submit one form per child.
Please fill out this form for the JF&CS PAL team to get to know your family. We will be in touch shortly after we reveiw this submission form. This form is confidential and will not be shared.
Parent/Guardian Information*

First NameLast Name
Relationship to the Youth *
Parent/ Guardian Email *
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Child *

First NameLast Name
Date of birth of child*

MonthDayYear
Date
Personal Pronouns *
What pronouns does the youth use?
What does the youth attend school?*
Is your family affiliated with a Synagogue or Temple? If so, which one?*
Please tell us briefly why you would like a mentor for your child? *
How did you hear about PAL Program?*

EmailSocial Media (Facebook, Instagram, etc.)Family or FriendCommunity Partner/OrganizationOther
For immediate questions about the PAL Porgram please contact Sarah Bernstein at sbernstein@jfcsatl.org.
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