The Arnold Shapiro Community Service Award Application
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
High School
*
Date of High School Graduation
*
-
Month
-
Day
Year
Date
Plans after High School:
*
Please write a short essay (a minimum of 250 words) describing what you have done for Congregation Etz Chaim and what Congregation Etz Chaim means to you. Then upload it below:
*
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