Student to Student Application 2026-2027
Thank you for your interest in the Student to Student program! Please fill out this form and submit. We will be contacting you this summer. For questions, please contact Rachel Nelson at rachel@jewishportland.org or 503-892-7415
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
High School
In 2026-2027, I will be a
Junior
Senior
Jewish Education (please describe)
I have visited Israel
on an organized program
on a private trip
not yet
If you visited Israel on an organized program, which program was it?
Synagogue Affiliation
Beit Haverim
Chabad
Congregation Ahavat Achim
Congregation Beit Yosef
Congregation Beth Israel
Congregation Kesser Israel
Congregation Kol Ami
Congregation Neveh Shalom
Congregation Shaarie Torah
Congregation Shir Tikvah
Havurah Shalom
Kol Shalom
P'nai Or
Other
Unaffiliated
Are you a member of a youth group?
Yes
No
If yes, which youth group?
I will have a car available next year:
Yes
No
Maybe
Parent/Guardian 1 Name
First Name
Last Name
Parent/Guardian 1 Email
example@example.com
Parent/Guardian 1 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian 2 Name
First Name
Last Name
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Short essay paragraph: Please explain why you are interested in the JCRC Student to Student program.
Submit
Should be Empty: