SHANA 8 Application and Registration
Use this form to register, select your payment option, and apply for scholarship for SHANA 7. More information and an FAQ about the program can be found at www.habonimdror.org/shana
First Name: *
Last Name *
Home machaneh: *
Current Eizor/University or Home Location: *
Please write where you are currently living and/or attending university, and if relevant which HDNA Eizor this in:
Phone Number: *
Email Address: *
Birthday
MM
/
DD
/
YYYY
Name of Parent/Guardian
Relationship to Participant
Parent/Guardian Email
Parent/Guardian Home Phone
Parent/Guardian Cell Phone
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