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Part I
Name:
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Address
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Phone (Cell):
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Email:
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Parents' Name:
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Parents' Phones (Cells and Works):
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Parents' Emails:
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School:
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Synagogue (if a member):
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Date of Birth:
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High School Graduation year:
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List your extracurricular activities. Include and describe your participation in pro-Israel activities in your community, at your school, youth group or synagogue (use additional page if necessary):
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Have you been to Israel before? If yes, when and with whom?
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Please list 2 references, one academic and one personal (name, e-mail and phone for each):
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Are you currently writing for your school or community newspaper? If so, please email us (tkeller@akivacleveland.org) a sample:
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Part II
We will conduct personal interviews in August, 2017. Please look at the prompts below. During your interview, we will discuss them.
Additional Information
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