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Jewish Student Leadership Institute Application
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
Date of Birth
*
(mm/dd/yyyy)
Please identify your past Jewish experiences, if any
*
(day school; Hebrew school; synagogue youth groups; camp, etc.)
Please name key Jewish influences in your life
*
(teachers; family members; rabbis; books)
What is your college major? What are some of your personal and/or career goals?
*
Which of the following interests you most?
*
(Check off all that are applicable)
Community Service
Holocaust Awareness
Israel Advocacy
Jewish Education
Judaic Studies
Other (specify below)
Other interests (if checked)
Describe briefly (3-5 sentences) why you want to participate in this seminar and what you hope to gain from it.
*
