International Seminar - Israel Youth Award
Registration Form



Name

Sex           Age

Address

City         State/Province

Country         Zip Code

Telephone: Work         Home

Fax

Email

Organization

Position (in organization)

Comments




* Last date for registration to the seminar is October 1, 1998.

** Upon receiving confirmation of your registration, you will be asked to send us a cheque for $100 - which covers both the cost of registration and participation in the seminar.