Name of donor
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High School Interview Form
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High School Interview Form
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Student- First Name
*
Student- Last Name
*
Student- Email Address
*
Mother- First Name
*
Mother- Email Address
*
Father- First Name
*
Father- Email Address
*
Address:
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Country of Residence
*
What is the best phone number to reach you? (include country code)
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Do you have a skype address?
Yes
No
If yes‚ what is it?
*
Which interview method do you prefer?
In New York Chof Beis Shvat
In Israel at Beit Chana
Other
Please fill out the following questions based on your above selection.
If you will be interviewing in New York:
Who will be traveling to New York? (Choose all that apply)
To select more then one:
press Ctrl button and select
Student
Mother
Father
How can you best be reached in New York? (please include local phone number)
What dates will you be in New York?
If you will be interviewing in Israel:
Who will be traveling to Israel? (Choose all that apply)
To select more then one:
press Ctrl button and select
Student
Mother
Father
How can you best be reached in Israel? (please include local phone number)
What dates will you be in Israel?
If you chose "Other"‚ please exlain why:
