Please make name and address entries Upper-Lower case, not all UPPER.
|First Name: *
||Last Name: *
|Two digit STATE + ZIP (or Province + Code)
PLEASE don't skip the state *
|Country: (Change if not USA)
one that fits
||Home Phone ("landline" only):
Cell Phone: *
Primary Email Address: * REQUIRED
Second Email Address if you have one
We send information by email only.
Please enter only personal email address, such as gmail, hotmail, msn, yahoo.
Not employment/corporate, government,
or LDS/BYU. You leave=address bad.
|Interest (Control-click ANY that apply)
ANY Optional Comment, etc.
1) This Organization has no affiliation with the Church, does not represent the Church, receives no support from the Church, is not sanctioned by the Church in any way; therefore, its actions cannot be attributed to the Church.
2) No Officer, Director, or member shall proselytize or act in any way that may be construed as having the purpose of proselytizing of descendants of Abraham in the State of Israel.
Your applying implies that you agree to support the B'nai Shalom Mission Statement.