College Students

The Temple Israel Center community would like to keep in touch with our students who are studying away from home. Holiday packages as well as mailings from the clergy will be sent to each student.

Please let us know if the student will be away from school for either semester or if there is a change in the student's address, phone, or email. Please remember that a new form must be filled out each school year.

Our clergy looks forward to staying in touch!

Student Information

Name*

First Last

College/University*

Year*

School Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Would you like to register a second student?

Yes
No

Second Student Information

Name of Student 2

First Last

College/University

Year

School Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Parent 1 Information

Parent 1 Name*

First Last

Parent 1 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent 1 Phone

Parent 1 Email*

Would you like to volunteer to help the College Committee?

Yes
No

Parent 2 Information

Parent 2 Name

First Last

Parent 2 Address

Please fill out if this address is different from Parent 1's address.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent 2 Phone

Parent 2 Email

Would you like to volunteer to help the College Committee?

Yes
No