What is your Address (In Israel-and Apt number)? (Please be as specific as possible and if there are any other instructions, please include-such as a different name on the door or Knisa or the like) *
Your answer
What is your Phone Number?
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What is your Email Address? *
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What date are you moving into the neighborhood?
MM
/
DD
/
YYYY
What city are you originally from?
Your answer
Any other questions or comments?
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