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Register Your Details
If you are an alumni and you would like to register your details on our database to keep informed about exciting news and events, please complete the form below.
(The Australian Friends respect your right to privacy and will not share your personal information)
PERSONAL INFORMATION:
Last Name:
*
Given Names:
*
Email Address:
*
Date of Birth:
Day:
1
2
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5
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7
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9
10
11
12
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Month:
January
February
March
April
May
June
July
August
September
October
November
December
Year:
Address:
Street 1:
Street 2:
Suburb/Town:
State (AUS only):
NSW
VIC
QLD
SA
NT
WA
TAS
ACT
Postcode:
Country:
Phone Numbers:
Daytime contact number:
Evening contact number:
Mobile:
COURSE INFORMATION:
Course Studied:
*
Undergraduate Semester/Year Program
Graduate Semester/Year Program (not including Masters Programs)
M.A. (Masters) Program
Gap Year/Freshman Program
Ulpan
BASP
Yad Vashem
Summer Institute
Mishpatim
Conflict Resolution
Mechina
Melton
Other
Other (if you selected "Other" please list the course(s) here):
Year Studied (if the course ran over more than year, list the final year that you studied):
*
General Comments (please include any other relevant information here):
Would you like to receive information about exciting news and events for alumni?
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