First Name *

Last Name *

Gender *

Pronouns *

Age: *

What grade will you be in this next school year? *
- Select Option 8th 9th 10th 11th 12th

What school do you currently attend? *

What is your religious/spiritual/secular affiliation? (This is optional and does not impact participation)

Will you have transportation available? *
- Select Option Yes No

T-Shirt Size *
- Select Option Adult - Extra Small Adult - Small Adult - Medium Adult - Large Adult - Extra Large

Dietary restrictions we should be aware of:

Access needs we should be aware of:

Phone *

Email *

Address Line 1: *

Address Line 2:

City: *

State/Province: *
- Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Afr/Can/EU/ME Armed Forces Americas Armed Forces Pacific Baker Island California Colorado Connecticut Delaware Federated State of Micronesia Florida Georgia Guam Hawaii Howland Island Idaho Illinois Indiana Iowa Johnston Atoll Kansas Kentucky Kingman Reef Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Navassa Island Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Palmyra Atoll Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territory of Pacific Utah Vermont Virgin Islands Virginia Wake Island Washington Washington D.C. West Virginia Wisconsin Wyoming

Zip/Postal: *

Primary Parent / Guardian Name: *

Primary Parent / Guardian Email: *

Primary Parent / Guardian Phone: *

Secondary Parent / Guardian Name:

Secondary Parent / Guardian Email:

Secondary Parent / Guardian Phone:

Please download and fill out these consent forms. Your student will need to bring these with them on the first day in order to participate. Thank you!

Please do your best to answer two of the following questions.  The first one is required.  For the second, please choose one from the three listed.

What are your hopes for this program? *

What's your leadership experience and how has that impacted you?

How do your interests and responsibilities outside of school shape you as a person?

Tell us about an experience you've had meeting someone different from you. What did you learn from that experience?

This question is for internal use only; please check all that apply. Past participation in Kaufman Interfaith Institute will not influence your admission into the Scholars program. *
2019 Week 1 Summer Day Camp participant
2019 Week 2 Summer Day Camp participant
2022 Summer Day Camp participant
2023 Summer Day Camp participant
2024 Summer Day Camp participant
UJS Programs with Scholars
Returning Solar
None of the above