One moment please...
New Student Information Form
Basic Information
Name
*
First Name
Last Name
Pronouns
*
Email
*
Verify Email
*
Phone Number
*
Home Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
School Information
Graduation Year
*
select one
2025
2026
2027
2028
2029
2030
University Attending
*
select one
Virginia Tech
Roanoke College
Radford University
Hollins University
Fraternity/Sorority (if applicable)
Residence Hall
select one
Ambler Johnston (East)
Ambler Johnston (West)
Campbell (Main)
Campbell (East)
Cochrane
Eggleston (East)
Eggleston (Main)
Eggleston (West)
GLC at Donaldson Brown
Harper
Hillcrest
Hoge
Johnson
Miles
New Hall West
New Residence Hall East
Newman
O'Shaughnessy
Payne
Pearson (East)
Pearson (West)
Peddrew-Yates
Pritchard
Slusher
Vawter
Whitehurst
Oak Lane
VT Corps of Cadets
Gallery at Alexandria
School Of
*
select one
VT - College of Agriculture and Life Sciences
VT - College of Architecture and Urban Studies
VT - Pamplin College of Business
VT - College of Engineering
VT - College of Liberal Arts and Human Sciences
VT - College of Natural Resources and Environment
VT - College of Science
Virginia-Maryland College of Veterinary Medicine
VT - Carilion School of Medicine and Fralin Biomedical Research Institute
VT - Graduate School
RC - Biology
RC - Business & Economics
RC - Chemistry
RC - Education
RC - English
RC - Environmental Studies
RC - Fine Arts
RC - Health and Human Performance
RC - History
RC - Math, CS & Physics
RC - Modern Languages
RC - Psychology
RC - Public Affairs
RC - Religion, and Philosophy
RC - Sociology and Public Health
RU - Davis College of Business and Economics
RU - College of Education and Human Development
RU - Waldron College of Health and Human Services
RU - College of Humanities and Behavioral Sciences
RU - School of Nursing
RU - Artis College of Science and Technology
RU - College of Visual and Performing Arts
RU - College of Graduate Studies and Research
Hollins University
Not listed
Major
Home Information
Parent/Guardian 1 Name
*
First Name
Last Name
Parent/Guardian 1 Email
*
Verify Email
*
Parent/Guardian 1 Phone #
*
Is Parent/Guardian 1's address the same as your home address?
*
Yes
No
Parent/Guardian 1 Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Are they a VT alum?
*
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
City
State
State/Province
ZIP/Postal Code
Country
Do you/your family belong to a synagogue in your hometown?
*
Yes
No
Name of congregation & city
*
Did you attend a Jewish Summer Camp?
*
Yes
No
Name of summer camp
*
How do you identify Jewishly?
*
Reform
Conservative
Orthodox
Reconstructionist
Renewal
Just Jewish
Exploring Judaism
Not Jewish
Other
If you selected other, please describe:
*
Getting Connected!
Let us know what you are interested in so we can connect you to all of our amazing programming!
What are you interested in?
*
Board Games
Service Work
Sustainability/Climate
Cooking/Jewish food
Women's Group
Fraternity & Sorority Life
Interfaith Work
Israel
Jewish Learning
LGBTQ+
Music - singing/song circle
Outdoor Programs
Self-Care/Mental Health Awareness
Social Justice
Spirituality
Sports
Video Games
Yoga
Sephardic/Mizrachi Culture
Other Interests
Travel to Israel - Birthright, Perspectives, Onward
Immersive Service Experiences - Alternative Spring Break
Professional Development
Leadership
Shabbat Experiences
Are there other things you are interested in? Let us know below!