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Mezuzah Interest Form
Just moved in and need a Mezuzah to complete the job?
Chabad is happy to provide Mezuzahs, on loan, to all students!
All you need to do is fill out this form and we'll be in touch with you about specifics ✌️
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Full Name
*
Your answer
Email address
*
Your answer
Phone number
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Your answer
What year are you?
*
Freshman
Sophomore
Junior
Senior
Grad student
Other:
What's your address on campus?
*
Your answer
Why do you want a Mezuzah?
*
Your answer
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