Aish Campus - Leadership


	Contact Information

	First Name :
	Last Name :
	Phone :
	Email :
	School Information
	University/College:
	Expected date of graduation
	Family Background
	Was your father born Jewish?
	00000000If converted, please discuss the circumstances

	Was your mother born Jewish?
	00000000 If converted, please discuss the circumstances

	Personal Information
	Have you participated on an Aish program before?
	00000000 If yes, please list which program(s) (include location, month, & year):

	Your current Jewish affiliation:
	List any groups, clubs, or fraternities/sororities you belong to. (Please indicate if you hold a position in any of these organizations and, what your position is):

	Describe your academic interests, hobbies, and extra-curricular activities:

	Briefly explain what you hope to gain from the Aish Campus Leaders Fellowship: