Name(Required) First Last Berkeley Email(Required) Non-Berkeley Email(Required) Phone(Required)Mailing Address (where we can send a check)(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Would you like to sign up to receive online payments?(Required) Yes No, I would like to receive a paper check Select Your Fellowship(Required)If you participated in more than one fellowship, please complete a form for each fellowship stipend. Crafting Consent Foundations of Judaism Foundations of Jewish Prayer Repair the World Spring 2023 Judaism, Spirituality and Social Justice Kol Yisrael Fellowship Schultz Fellowship Student Board Senior Booze and Schmooze Tell us in a few sentences what you enjoyed about your fellowship this semester.(Required)Blank W-9 Form HiddenW-9 upload: Required for stipends, payments over $600Max. file size: 100 MB. Δ
