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Personal Information
School:
Gray Academy Of Jewish Education
Class of:
Joseph Wolinsky Collegiate
Class of:
Talmud Torah
Class of:
I.L. Peretz Folk School
Class of:
Ramah Hebrew School
Class of:
Surname:
Given Name:
Middle Name:
Maiden Name:
(if applicable)
Date of Birth:
Month
January
February
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Marital Status:
Please Select
Single
Married
Divorced
Widowed
Spouse/Partner:
(if applicable)
Spouse/Partner Alumnus/Alumna?
(if applicable)
Home Address
Street:
City:
Province/State:
Postal/Zip Code:
Country:
Work Address
Street:
City:
Province/State:
Postal/Zip Code:
Country:
Where do you prefer to be contacted?
Work
Home
Methods of Contact
Home Phone Number:
(
)
-
Cell Phone Number:
(
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Work Phone Number:
(
)
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Email Address(es):
If you are graduating in the current year, please complete the following.
Will you be attending University?
Yes
No
If yes, where?
Father’s Name:
Alumnus?
Yes
No
Graduation Year:
Father's Phone Number:
(
)
-
Mother’s Name:
Alumna?
Yes
No
Graduation Year:
Mother’s Phone Number:
(
)
-
Parent(s) Address:
City:
Province/State:
Postal/Zip Code:
Country:
Sibling's Name:
Sibling's Date of Birth:
Month
January
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Currently attends Gray Academy?
Yes
No
Alumnus/Alumna?
Graduation Year:
Sibling's Name:
Sibling's Date of Birth:
Month
January
February
March
April
May
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July
August
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Day
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Currently attends Gray Academy?
Yes
No
Alumnus/Alumna?
Graduation Year:
Sibling's Name:
Sibling's Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
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Day
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Currently attends Gray Academy?
Yes
No
Alumnus/Alumna?
Graduation Year:
Professional & Educational Information
Current Profession:
Current Employer:
Post Secondary Institution:
Degree/Diploma:
Post Secondary Institution:
Degree/Diploma:
Post Secondary Institution:
Degree/Diploma:
Highest Degree Earned:
Are you willing to be a resource for current students who have career-specific questions?
Yes
No
Children
Name:
Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
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Day
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/
Currently attends Gray Academy?
Yes
No
Alumnus/Alumna?
Graduation Year:
Name:
Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Day
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/
Currently attends Gray Academy?
Yes
No
Alumnus/Alumna?
Graduation Year:
Name:
Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Day
1
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30
31
/
Currently attends Gray Academy?
Yes
No
Alumnus/Alumna?
Graduation Year:
Professional or Personal Achievements/Recognition
Please tell us about yourself (max. 250 words):
Example: John Doe (Class of '82) is a Talmud Torah and Joseph Wolinksy graduate who received a BA in Psychology from the University of Winnipeg. John is the recent recipient of the Young Leadership Award from the Jewish Federation.
Please check here if you do not wish your personal information to be shared for purposes other than JWC/Gray Academy Alumni Association Initiatives.
Please check here if you do not wish to be profiled in brief in an Alumni newsletter.
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