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* 1. Your Name:

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* 2. Gender

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* 3. Your Email:

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* 4. Contact Number:

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* 5. College or University you attend:

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* 6. When is your expected graduation date?

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* 7. Are you a member of a student group that addresses the Palestinian-Israeli issue?

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* 8. How many students are currently part of your group?

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* 9. What types of activities, events, or campaigns does your group support? (check all that apply)

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* 10. Is your group currently running a BDS Campaign?

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* 11. If yes, what companies are you targeting?

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