Name:

School/University:

Year:

Major:

Address:

Email Address:

School Phone Number:

Permanent Phone Number:

Cell Phone Number:

How many times have you been to Israel?

Please list the year and name of program in which you participated?

Please tell us about other experience with Israel Education or Israel advocacy:

Why do you think Israel education and advocacy is important?

Describe any extracurricular or volunteer activities in which you participate:

How would you describe the state of Israel awareness on your campus?

What do you think should be done to promote Israel awareness and education on campus?

Tell us why you think you would make an excellent Israel intern?