Application For The Ultimate Jewish Online Course
Classes start Tuesday May 25, and run for 8 weeks
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Email *
First Name *
Last Name *
Phone *
123-456-7890
Date of Birth *
MM
/
DD
/
YYYY
Education
Current Status *
What is the name of your current university? *
If you already graduated, tell us the name of the school you attended.
Are you a member of a fraternity or sorority? *
If yes, please tell us which one *
If no, enter N/A
Jewish Education During and/or After College
Have you completed any of the following programs? *
Select all that apply
Required
If you clicked any program above, please list the name of the program and when you completed it *
If you selected multiple programs, list all dates (program name - date). If you selected NONE, enter N/A.
Did you go to Israel with Birthright? *
Have you been to Israel on a subsidized program? *
In addition to (or instead of) Birthright.
If you entered "yes" above, please enter the name and date of the program *
If you selected multiple programs, list all dates (program name - date). If you selected NONE, enter N/A.
Jewish Background
Please describe your Jewish affiliation before college *
Choose the one that fits best
Family History *
Please select all that apply
Please explain any conversion history if applicable *
If not applicable, enter N/A
Almost Done!
How did you hear about The Ultimate Jewish Online Course? *
If a specific person referred you, please tell us his/her name. If it was more than one person, enter both names.
Anything else? *
Please let us know anything else you think we need to know about you
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