TIC College Connect - Form - Temple Israel Center

Thank you for your interest in TIC College Connect. Please fill out the information below.

Parent Information

* First Name

* Last Name

* Email

* Phone Number

Would you like to help assemble care packages?

Please Select OneYesNo

Student Information

* Student 1 Name

* Student 1 College/University

* Student 1 Address: street, city, state, zip code

* Student 1 Class Year

* Student 1 Email Address

Student 1 Phone Number

* For which holiday(s) would you like us to send care packages to your child this academic year? Please note that we can only send packages to U.S. addresses. Since many students study abroad or have different schedules, we ask that you check your calendar before selecting. Packages are typically sent 1-2 weeks before each holiday, so please only select holidays when your child will be on campus.

ChanukahPurimPassover

Is there anything you would like to share about your child and his/her program?

Would you like to add a second child?

Please Select OneNoYes

Student 2 Name

Student 2 College/University

Student 2 Address: street, city, state, zip code

Student 2 Class Year

* Student 2 Email Address

Student 2 Phone Number

For which holiday(s) would you like us to send care packages to your child this academic year? Please note that we can only send packages to U.S. addresses. Since many students study abroad or have different schedules, we ask that you check your calendar before selecting. Packages are typically sent 1-2 weeks before each holiday, so please only select holidays when your child will be on campus.

ChanukahPurimPassover

Is there anything you would like to share about your child and his/her program?

Would you like to add a third child?

Please Select OneNoYes

Student 3 Name

Student 3 College/University

Student 3 Address: street, city, state, zip code

Student 3 Class Year

Student 3 Email Address

Student 3 Phone Number

ChanukahPurimPassover

Is there anything you would like to share about your child and his/her program?

If you're interested in helping support this amazing initiative, please make a tax-deductible contribution to help fund the TIC College Connect program. Please enter the amount in the box below.

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