CUFI on Campus Summit 2023
College Conference Scholarship Application
*Please do not leave this page idle as it will time out and you will have to start over.*
Contact Information
First Name
Last Name
Address 1
Address 2
City
State/Province
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Europe
Armed Forces Pacific
Armed Forces the Americas
California
Colorado
Connecticut
Delaware
District of Columbia
Fed. States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Is.
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Date of Birth
Gender
Male
Female
Phone Number
Email Address
Yes, I would like to receive email communications from CUFI on Campus.
Yes, I would like to receive email communications.
If your summer address is different than the address above, please provide.
CAMPUS INFORMATION
Will you be enrolled as a full-time student in an accredited U.S. college or university for the next full academic year?
Yes
No
What college/university will you be attending in Fall 2023?
In what city and state is your campus?
What semester and year do you plan on graduating?
Spring 2023
Fall 2023
Spring 2024
Fall 2024
Spring 2025
Fall 2025
Spring 2026
Fall 2026
Spring 2027
Fall 2027
Spring 2028
Uncertain
Already Graduated
What is your major/course of study?
Do you attend a Historically Black College or University?
Yes
No
Is there a CUFI on Campus chapter at your school?
Yes
No
If yes, please list your role within your chapter.
If not, would you be willing to start one?
List any Israel-related advocacy events that you have attended in the past:
Are you involved in any other pro-Israel organizations? If so, please list them below.
Have you visited or are planning to visit Israel?
Yes
No
If yes, when and with which organization/church?
Are you currently registered to vote in the United States?
Yes
No
If no, why?
Do you attend church regularly?
Yes
No
If yes, list your Church name, Pastor's name, City, and State:
Would you like to nominate your pastor to be considered for a CUFI Pastor’s Trip to Israel?
Yes
No
What Israel-related topics are you most interested to learn about?
GUARDIAN/EMERGENCY CONTACT INFORMATION
Emergency Contact's First Name
Emergency Contact's Last Name
Relationship
Emergency Contact's Cell Phone:
Emergency Contact's Email Address
ESSAY PORTION
Responses to the essay questions below must be at least 5 sentences in length and demonstrate college level writing skills. Effort in this section is one of the determining factors in a student receiving a sponsorship to attend the CUFI Summit. Please be sure to proofread spelling and grammar errors before submitting this application for review. Thank you.
Please share your faith background.
Do you consider yourself to be "pro-Israel"? If yes, please explain using any biblical, political, personal, or historical reasons. If no or unsure, please explain.
What do you hope to bring back to your campus after attending this conference?
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