Applicant Information – Miami March of the Living

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March of the Living 2022-2023 Application

Applicant Information

RM_Stats

Please complete all fields to the best of your ability.

*Denotes a required field

Registrant(Teen) First Name^*

Registrant(Teen) Last Name^*

Registrant(Teen) Email Address^*

Enter email again^*

Preferred First Name that would appear on name tags

Please upload your most recent headshot so that we can see just your face (JPG or PNG preferred)^*

Date of Birth^*

Home County^*

What is your gender identity?^*

Male
Female
I prefer to describe my gender identity

What are your preferred pronouns? (Pronouns are the part of speech used to refer to someone in the third person. We want to know how to respectfully refer to you!)^*

he/him/his
she/her/hers
they/them/their

Street Address^*

City^*

State^*

Zip Code^*

Registrant(Teen) Cellphone Number^*

Home Phone

T-shirt Size^*

Jacket Size^*

Do you speak Hebrew?^*

Do you speak Spanish?^*

Name of school you currently attend:^*

Grade as of September 1, 2022^*

11
12

If you selected other, name the School you currently attend^*

Please provide your current GPA (unweighted)^*

Are you taking any AP classes?^*

Yes
No

Please list AP classes you are taking.^*

Please list the name of the Middle school you attended^*

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Contact

4200 Biscayne Blvd #1, Miami, FL 33137
miamimotl@caje-miami.org

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