Tikkun Olam Camp Referral Form
Please recommend a student for Tikkun Olam Camp 2008. Campers must be entering 9th through 12th grade in Fall 2008. Please provide as much information as possible.
* indicates a required field
*Your Name:
*Your Email Address:
*Your Phone Number:
Your Relationship with student you are referring:
Parent
Grandparent
Friend of the family
Rabbi
Educator
Youth Group Leader
Other (please fill in)
Are you, or is your child, a past participant of
Tikkun Olam
Camp?
Yes
No
*Student's Name:
*Student's Phone Number:
Student's Email Address:
Student's Mailing Address:
City/State/Zip:
Student's Age:
Student's School:
Parent 1 Information:
Name(s):
Home Phone Number(s):
Work Phone Number(s):
Cell Phone Number(s):
Parent 2 Information:
Name(s):
Email
Address(es):
Home Phone Number(s):
Work Phone Number(s):
Cell Phone Number(s):
Please contact Marissa Garfield at 858-279-2740 or
marissa@jcfsandiego.org
with any questions.
Jewish Community Foundation
4950 Murphy Canyon Road, San Diego, CA 92123
telephone 858-279-2740 | fax 858-279-6105
©2008 Jewish Community Foundation. All Rights Reserved
