Name (as appears on birth certificate or passport):
*Please note that the charge will be in American dollars.
Applicant's Email Address:
I hereby apply for enrollment of my child for his/her participation in the
program indicated above. I agree to all terms
of payment. I understand that USY summer programs are only
open to USY members and that my child will be required to join a USY chapter
prior to final acceptance. I also understand that all USY program participants
must be Jewish (i.e., born to a Jewish mother or converted to Judaism).
A $750 deposit is required in order to reserve your spot and qualify for the Early Bird discount. Final prices are set to be announced around November 15, 2012. Once prices are officially announced, you will be notified immediately and you will have 2 weeks to cancel without penalty. After this two-week period has concluded, should an application be withdrawn for any reason, a $150 processing fee will be withheld provided such written cancellation is received by March 1, at which point additional cancellation fees will apply. All applicants must complete the second half of the early bird application once the prices are announced.
Parent's typed signature:
Email address for confirmation: