Phone *

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I am a: *

Student

Faculty Member

Employee of a Non-Profit Organization

Other

This is in relation to *

A significant anti-Semitic or anti-Israel event or visual

A BDS or other anti-Israel vote

A campaign for Student Government where a pro-Israel student is running against a student with an anti-israel platform

Other that will significantly affect life on campus for Jewish and pro-Israel students

Due by:

Is there a definitive "Due By" date? If so, please specify:

MM

DD

YYYY

On behalf of myself and the organization I represent that... *

What is produced by Artists 4 Israel for this purpose is the sole property of Artists 4 Israel. What is produced can only be used specifically in regards to the purpose expressed in this application unless by prior written consent of Artists 4 Israel. In any and all communications with donors and other supporters, Artists 4 Israel will be noted for its assistance. You have the right to make this request on behalf of the organization listed in your application and agree that what is produced will be used for the purposes described in this application. You hold Artists 4 Israel harmless and indemnify Artists 4 Israel, its employees, artists, Directors and others against any and all claims arising from this undertaking.

I agree