Vanderbilt Hillel · Class of 2028 Intake Form

Student's Contact Information

Name *

First Name

Last Name

Student's Birthday *

(mm/dd/yyyy)

What is your anticipated year of graduation? *

Student's Cell Phone *

School E-mail

Verify Email

Personal E-mail *

Verify Email *

Home Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Guardian 1's Name *

First Name

Last Name

Guardian 1's Email *

Verify Email *

Guardian 1's phone number

Same home address as the student?

Yes

No

Guardian 1 Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Guardian 2's Name

First Name

Last Name

Guardian 2's Email

Verify Email

Guardian 2's phone number

Same home address as the student? *

Yes

No

Guardian 2 Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

I am Interested in... *

Please check all that apply.

Jewish Life and Holidays (Shabbat Services and/or Dinner)

Israel Advocacy ('Dores for Israel)

Community Service Projects (Challah for Hunger)

Educational Programs

Outdoor Adventure/Hiking

Travel Experiences (Alternative Spring Breaks or Birthright)

LGBTQ Programming

Have you participated in any Jewish youth groups? *

Please select all that apply

BBYO

NFTY

USY

Other

Which options best describe your diet? *

Please select all that apply

Vegan

Vegetarian

Pescatarian

Gluten Free

No Red Meat

Dairy Free

Kosher Style

OU Kosher

None

Do you have any dangerous food allergies we should be aware of? *

Please select all that apply. Do not include food preferences, just serious allergies.

Gluten

Tree Nuts

Strawberries

Soy

Peanuts

Other

Please tell us about the severity of the allergies you selected or additional allergies. *

severity of reaction and required treatment

Would you like to be placed on the waitlist for FYSH Fest?

FYSH Fest is a pre-orientation program which is scheduled to begin the afternoon of Thursday, August 15th and conclude before Shabbat on August 16th. We will provide programming for students and families for both days before they move into their dorms with the remainder of the campus community at the regularly scheduled Saturday morning move-in time. Student participants will be engaged by upperlassmen and matched with a mentor as they become comfortable on campus, in Nashville, and at Hillel.

Yes, place me on the waitlist for FYSH Fest

No, I do not want to be on the waitlist for FYSH Fest