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Student Information  
First Name *
Middle Name
Last Name *  
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Please retype your e-mail address *  
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Have you ever been to Israel? *  Yes   No
 
Please list your college address (where you will receive you subscription to RJ Magazine)
Address at College *  
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Please list your permanent address  
Home Address
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Communications Agreement
Students who serve as a KESHER Reform Jewish Liaison (RJL) will receive the RJL Quarterly Newsletter and the RJCampus monthly newsletter. You may also receive occasional communication from the Union for Reform Judaism and KESHER.
Please type your initials in the box to confirm your understanding of the RJL Communications agreement:    *
   
Please include my e-mail address in the KESHER Directory on the KESHER website, which will give prospective Reform Jewish students the ability to contact me directly about Reform Jewish life on my campus.