Jewish Youth Assembly 2023 Pre-Registration

By completing this form, you will be the first to receive the JYA application when it opens. This form is not an application.

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* 1. Full name

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* 2. Email Address

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* 3. Your date of birth

Date

Date

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* 4. Current country of residence

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* 5. Is your current country of residence the same as your birth country?

Yes

No

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* 6. If you answered no to the previous question, what is your birth country?