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SHANA 7 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
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First Name:
*
Your answer
Last Name
*
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Home machaneh:
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Choose
Galil
Gesher
Gilboa
Miriam
Moshava
Tavor
Naaleh
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:
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Phone Number:
*
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Email Address:
*
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Birthday
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DD
/
YYYY
Name of Parent/Guardian
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Relationship to Participant
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Parent/Guardian Email
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Parent/Guardian Home Phone
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Parent/Guardian Cell Phone
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