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University students

Mezuza bank

Show your Jewish Pride!

Do you want a Mezuza for your dorm room or apartment?

We have one for you free of charge! (With a deposit)

Fill out this form to have Rabbi Shneur or Miriam come put up the Mezuza with you.
Full Name*

First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*

Home address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Apartment/dorm*
Year*
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