* 1. Your Name:

* 2. Gender

* 3. Your Email:

* 4. Contact Number:

* 5. College or University you attend:

* 6. When is your expected graduation date?

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

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

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

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

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

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