2027 BJE March of the Living Application Part 1

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BJE March of the Living 2027 Application Part 1:

To be completed by the participant

Confirmed dates and pricing should be available in September. When details are ready to share, we will email you a link to complete Part 2 of the application (to be completed by the parent/guardian).

TEEN INFORMATION

First name

Middle name

Last name

Nickname - If you go by a different name, please include it here:

Gender:

FemaleMaleI prefer to self describe (please do so in "My preference is" box below)

If you 'prefer to self describe', what are your preferred pronouns?

Birthday (month)

Birthday (Day)

Birthday (Year)

Address

City

State

Zip Code

Cell Phone Number

TEEN Email Address (that you check most often)

EDUCATIONAL INFORMATION

What school do you attend?

Your grade in September 2026?

If 'other' - please explain

Are you planning on taking AP Exams in May?

YesNo

PARENT / GUARDIAN CONTACT INFORMATION

Who is the primary contact?

Parent/Guardian 1Parent/Guardian 2

Contact Information for Parent/Guardian 1

First Name

Last Name

Cell Number

Email Address

Contact Information for Parent/Guardian 2

First Name

Last Name

Cell Number

Email Address

FINANCIAL AID

Would you like to receive information regarding financial aid?

TEEN WELLNESS - this information is confidential.

Have you received both doses of the COVID-19 vaccine? (please note, a booster may be required depending on date of vaccination)

YesNo

Do you take daily medication?

YesNo

Have you seen a mental health professional in the past two years?

YesNo

2027 BJE March of the Living Application Part 1

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