Application Deadline is Friday, September 10, 2021 Student Name First Last Parent(s) Name(s) First Last Home Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email College or university you are attending in the 2021-2022 academic year.* Please write a brief essay on your understanding of Jewish Family Services’ impact in and for the community and suggest innovative ideas on how college students can support the mission of JFS and serve those in need.*NOTE: JFS may use your entry in publicity materials. May we add you to our mailing list?* Yes No