Participant Questionnaire

Name*

First Name Last Name

1. Why would you like to join our program?*

2. What do you hope to achieve academically?*

3. What do you hope to achieve religiously?*

4. How did you hear about our program?*

5. Where do you see yourself in three years from now?*

6. What grade level do you think you are at academically?* a. In Judaic studies? b. In secular studies?

7. What do you think is your strongest subject?* a. In Judaic studies? b. In secular studies?

8. What do you think is your weakest subject?* a. In Judaic studies? b. In secular studies?

9. What do you like to do in your free time and what interests would you like to pursue?*

This form is to be completed by the participant himself