AJU Registration 2024-2025

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Please verify reCaptcha before submitting the form.

Temple Shalom members, please type in your name above and it will pull up your account and populate the name fields.

Once you have completed this form, your information will be sent to AJU and you will hear from them about the necessary steps for enrollment at the university. One student per form, please.

Questions? Please contact Director of Education Deborah Niederman, RJE, at dniederman@templeshalomdallas.org.

* Student's First Name

* Student's Last Name

* Student's Mobile

* Student's Email

* Parent?Guardian First Name

* Parent/Guardian Last Name

* Parent/Guardian Email Address

* Parent/Guardian Mobile

Emergency Contact Name (if different from Parent/Guardian)

Emergency Contact Mobile Number

* Any allergies, medical concerns or learning difference we should be aware of in order to ensure your safety and success?

Please Select OneYesNo

Please share details about any allergies, medical concerns or learning differences:

* Grade as of 9/1/2024

Please Select One9th Grade10th Grade11th Grade12th Grade

* Please choose courses you are enrolling in:

Fall Semester: Jewish Ethics and Contemporary Decision MakingSpring Semester: Introduction to the History, People and Culture of Israel

* My parent/guardian agrees that my photo may be taken for publicity purposes.

YesNo

By submitting this form, I agree to the policies and procedures of the Temple Shalom.

Sat, September 7 2024
4 Elul 5784

Sat, September 7 2024 4 Elul 5784

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