Apply to Jewish UnCamp

Ready to sign up?

Get it done in 3 easy steps and you're on way to an UNbelievable summer.

1.

Fill out the application below. (Mom and Dad, this is your daughter's job)

2.

Submit and pay your $50 application fee

3.

Get ready for a life-changing summer with your new best friends from around the world.

HELPFUL TIPS

If you need a scholarship, make sure to check that off on your application, then watch your inbox for instructions.
Make sure you know the name, email and number of the person who's going to write your recommendation. That can be a teacher, mentor, employer, counselor or anyone who knows you well.
Have a credit card ready to pay the application fee after you click Submit.

Please do not book your ticket until you get your acceptance email from us.

If you have questions or need help, we'd love to talk! Call us at 718-604-0088 or email teens @jewishuncamp. org.

Jewish UnCamp Summer Application

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Contact Information

First Name

Middle Name

Last Name

What is your nickname, or, what do you like to be called? (If it's the same as your first name, please enter your first name in the field below. Example: Sarah)

Date of Birth (mm/dd/yyyy)

mm/dd/yyyy

Cell Phone

Home Phone

Email Address (Camper email only)

***WARNING*** Only put CAMPER's email address in this field. NOT parent's email address.

Facebook Name

Hebrew name, if known

Mother's Hebrew Name, if known

Permanent Address

Street

City

U.S. State

Postal Code

Country

State/Province if outside of the United States

School Information

Full Name of School

Your grade this past year

School Contact Person

School Phone

Parent/Guardian Information

Father's First Name

Father's Last Name

Father's Cell Phone

Father's Email

Mother First Name

Mother Last Name

Mother Cell Phone

Mother's Email

Would you prefer to enter a Guardian?

Yes, Please

Guardian's Name

Relationship to you

Guardian's Phone

Guardian's Email

Parent's Marital Status

Who should we contact about payment?

Referral Information

How and where did you hear about the Jewish UnCamp?

Friend Family Facebook Online SearchCTeen LeaderCTeen Shabbaton I’m an Alum!NCSYTeacherChabad HouseSchool Other

If other, please provide details:

If you heard about us from a family member, friend or teacher, please provide the information below.

Referral First Name

Referral Last Name

Referral Phone

Referral Email

Would you like to add a referral name?

Yes, please

Ref 2 First Name

Ref 2 Last Name

Ref 2 Cell Number

Ref 2 Email

Scholarship Information

Do you need a scholarship in order to attend? If yes, you’ll receive a link to the scholarship form by email.

YesNo

Who is the best person to contact about this?

What is the best way to contact this person?

Sister & Friends Information

Any Friends or Sisters Registering?

Sister or Friend Name

Sister or Friend Phone Number

Emergency Contact Information

Please provide 2 emergency contacts.

Contact Name (1)

Relationship (1)

Cell Phone (1)

Contact Name (2)

Relationship (2)

Cell Phone (2)

Page 2

Help us get to know you

What are your special interests and talents? (music, sports, drama, debate, politics, etc.)

What are you most looking forward to?

Is there anything else you want us to know about you?

Page 3

Medical Information

Do you have any medical, dietary, or other needs?

Do you have any allergies, including penicillin?

Please list any medications you’ll be taking during the trip. If there are none write none.

Do you have any restrictions on activities? If so, please explain.

Recommendation Information

Please provide the name and contact information for the person who is going to write your letter of recommendation, such as a teacher, employer, or adult friend (not your parent).

We'll email this person directly to request the recommendation.

First Name of Recommendation

Last Name of Recommendation

Phone

Email (Warning! Do NOT enter your email address. Please enter the email of the person who'll be writing your letter of recommendation!)

I give permission to Jewish UnCamp and Bais Chana Women International to use photos, written quotes, audio or video of me in their promotional materials or for other non-profit purposes.

I agree to abide by all Bais Chana Women Intl safety and health protocols.

Page 4

Next you will have the opportunity to review your application. When you click SUBMIT, you will be directed to the payment page. Have your credit card ready, your $50 application fee must be paid now in order for your application to be considered. You can also make full or partial payment on the program and bus fees.

Summer UnCamp Fees

Application Fee - $50 (Must be paid with your application in order for it to be complete)

Program Fee - $3,600

Transportation (from airport to campsite, and return) - TBD (Must be paid before camp in order to reserve a seat on the bus)

If you need a deferred payment plan, please email info@baischana.org or call 718.604.0088.

If you checked Yes to the Scholarship question, you will receive the Scholarship Application by email.

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Contact Information

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Jewish UnCamp Summer Application

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