The Western Wall Heritage Fund  

Registration Form Video Conference



Contact name*
e-mail*
Phone*
Name of School*
Address
e-mail
Phone*
Web Address
Description of School*
Target community*
Age
Did students visited
the Western Wall?
Did students participated
in a Videoconference before?
Religion:
Comments:
Number of participants*
Hours Differences*
Tech Person*
e-mail*
Phone*
Video Conference System
ISDN / IP number*
Phone during broadcast*

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