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Mezuzah Form
This form is a user agreement for accepting a Mezuzah from Chabad UW.
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Email
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Your email
Full Name:
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Your answer
What is your Jewish name? Please enter your jewish name and your mothers.
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Your answer
I agree to the following terms and will adhere to them.
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I will treat the Mezuzah with resepct.
I will notify Rabbi Mendel if the Mezuzah goes missing or is defaced.
I will return the Mezuzah to Chabad UW when I move (or I will take it with me to my next residence).
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Please share a short message of gratitude for the donors who generously sponsor the Mezuzot for students.
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Your answer
A copy of your responses will be emailed to the address you provided.
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