Hillel at Virginia Tech · New Student Information Form

Basic Information

Name

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First Name

Last Name

Pronouns

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Email

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Verify Email

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Phone Number

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School Information

Graduation Year

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University Attending

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Fraternity/Sorority (if applicable)

Residence Hall

School Of

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Major

Home Information

Parent/Guardian 1 Name

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First Name

Last Name

Parent/Guardian 1 Email

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Verify Email

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Parent/Guardian 2 Phone #

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Are they a VT alum?

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Yes

No

Parent/Guardian 2 Name

First Name

Last Name

Parent/Guardian 2 Email

Verify Email

Parent/Guardian 2 Phone #

Is their address the same as parent/guardian 1?

Yes

No

Parent/Guardian 2 Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Do you/your family belong to a synagogue in your hometown?

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Yes

No

Name of congregation & city

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Did you attend a Jewish Summer Camp?

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Yes

No

Name of summer camp

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How do you identify Jewishly?

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Reform

Conservative

Orthodox

Reconstructionist

Renewal

Just Jewish

Exploring Judaism

Not Jewish

Other

If you selected other, please describe:

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Getting Connected!

Let us know what you are interested in so we can connect you to all of our amazing programming!

Other Interests

Travel to Israel - Birthright, Perspectives, Onward

Immersive Service Experiences - Alternative Spring Break

Professional Development

Leadership

Shabbat Experiences

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