enLIGHTen Winter 2019

Project enLIGHTen

To find out more about this amazing program - complete the form below.

We hope to be in touch with you shortly.

- Project enLIGHTen

First Name

Last Name

Date of Birth

Email Address

Mobile Phone

High School

University or College

What degree are you pursuing or have you pursued?

What year in school are you currently (if applicable)?

If you are not in school, how would you describe your current vocation?

Please list any jobs, internships or past work experience

Please list and explain any Jewish educational program that you have been part of (including Hebrew school)

Do you have any dietary restrictions? If so please specify.

Please list any extra curricular activities, hobbies and organizations that you are a part of

Have you ever been to Israel before? In what capacity?

What religion were you born into?

What religion were your biological parents born into? (Father)

What religion were your biological parents born into? (Mother)

What religion were your maternal grandparents born into? (Grandfather)

What religion were your maternal grandparents born into? (Grandmother)

What religion were your paternal grandparents born into? (Grandfather)

What religion were your paternal grandparents born into? (Grandmother)