Congregation Beth-El Zedeck College Students

Beth-El Zedeck would like to help college students celebrate with a High Holy Day care package!

Please complete this form for each undergraduate student in your family. (We regret that we cannot send packages to graduate students.) Address information must be confirmed/received anew. Packages will be sent to the first 50 students and can only be mailed to Beth-El Zedeck members in the continental U.S.

We must have all addresses no later than Thursday, August 31. Thank you!

Student First Name: *

Student Last Name: *

School Name *

Year in College *

Student Contact Information

Street *

Street 2

City *

State *

ZIP *

E-mail address *

Parent Contact Information

Name(s) of Parent(s)

Email Contact for Parent