College Form - Congregation Beth Israel

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College Form

College Form

Name*
First Last
Phone*
Student Name*
First Last
Student Cell Phone*
Student Email*

Email and text message will be our primary tools for communication, kindly provide this information.
Expected year of graduation*
College/University*
Current Status*
- Undergraduate student
- Graduate student
Are you interested in assisting in the planning of programs and acts of kindness for the Beth Israel college students?*