Buffalo Community of Learners Madrichim Information Form 2026-2027
ALL TEENS ARE ELIGIBLE TO PARTICIPATE IN OUR MADRICHIM PROGRAM REGARDLESS OF TEMPLE AFFILIATION. Dear Parents, please share this form with your teen and have them fill it out! Please complete the information as completely and honestly as you can so we can plan the best possible experience for you as a Madrich or Madrichah this year!
What is your preferred name?
*
First Name
Last Name
What are your pronouns?
*
She/Her
He/Him
They/Them
Other
What is your cellphone number?
Please enter a valid phone number.
Format: (000) 000-0000.
What is your email?
example@example.com
How old are you?
*
Parent/Guardian 1 Name
*
First Name
Last Name
Parent/Guardian 1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian 1 Email
*
example@example.com
Parent/Guardian 2 Name
First Name
Last Name
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian 2 Email
example@example.com
The best way(s) to reach me are:
*
Emails to me
Texts to me
Calls to me
Emails to BOTH my parents
Texts to BOTH my parents
Calls to BOTH my parents
Email/Text/Call ONLY Parent/Guardian 1
Email/Text/Call ONLY Parent/Guardian 2
What congregation does your family belong to?
*
Congregation Shir Shalom
Temple Beth Tzedek
Unaffiliated
Other
Do you want to be added to a potential carpool?
*
Yes
No
What school do you attend?
What grade will you be in this upcoming school year?
*
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Do you need a confirmation letter for National Honor Society?
*
Yes
No
Have you been a Madrich(a) before? Please tell us where, in what grades, and for how long.
*
What grade level(s) would you most prefer to work with?
*
Kindergarten / Grade 1
Grades 2-3
Grades 4-5
Grades 6-7
Office/Administration help
No Preference
Describe one skill set that you can offer in a religious school classroom:
*
Describe one skill set you would like to develop this year:
*
Do you have any questions or concerns about the Madrichim Program at B’COL this year?
*
Do you have any accommodation requests that will enhance your experience as a madrich(a)?
I agree to do my best to attend 80% or more of this year's Madrichim Activities and Buffalo Community of Learners sessions (25 Sunday mornings, 8:45AM - 11:45). I pledge to arrive on time, to dress appropriately, and to conduct myself with dignity.
*
I agree
I do not agree
Submit
Should be Empty: