Nitzavim "Roots" Retreat Application

Retreat Application
Name*

First NameLast Name
Email*
example@example.com
WhatsApp Phone Number*
Please enter a valid phone number.
Israeli Phone Number*
Please enter a valid Israeli phone number (05x)
Gender*

MaleFemale
High School Attended*
Other High School
Gap Year Program*
Other Gap Year Program
Expected University*
Other University
Expected University Graduation*
Expected University Degree*
Emergency Contact Full Name*

First NameLast Name
Emergency Contact Relation*
Emergency Contact Phone Number*
Please enter a valid phone number.
How did you hear about us?*
Why are you a good candidate to join this Shabbaton?*
Allergies
List any preferred roommates
Should be Empty: