Jewish Learning Fellowship

Jewish Learning Fellowship Intake Form

Name*
First Last
Cal ID*
Birthday*
MM slash DD slash YYYY
Non Berkeley Email Address*
Berkeley Email Address*
Phone*
How did you hear about JLF?*
Year of Graduation*
We'd love to hear more about you. Please tell us your Jewish story in a short paragraph.*

Parent/Guardian Information
Parent/Guardian 1 Name*
First Last
Parent/Guardian 1 Preferred Phone Number*
Parent/Guardian 1 Preferred Email*
My First Parent/Guardian*
Parent/Guardian 1 Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian 2 Name
First Last
My Second Parent/Guardian
My Second Parent/Guardian
Parent/Guardian 2 Preferred Phone Number
Parent/Guardian 2 Preferred Email Address
Parent/Guardian 2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent Alum Information
Did either of your parents attend UC Berkeley?*
Parent Name*
First Last

Parent/Guardian Information