Student Info Form

Want to find out about Jewish Life on Campus?
Hillel will provide you info about Jewish campus events and holiday programs.

* First Name

* Last Name

* What University do you attend?

* Class of

* Undergrad or Grad?

* Email

* Cell/local Phone

Campus Box#

Local Address

Address Line 2

City

State

Zip Code

Date of Birth

Major

* Permanent Home Address

Address Line 2

* City

* State

* Zip Code

* Home Phone

* Parent(s) Name(s)

* Parent's Email (1)

Parent's Email (2)

Relatives who are Wash U Alumni

Other Interests

Occasionally Hillel gets requests for prospective students who would like a student host to show them around campus for a night.

Check all that apply

I am willing to host prospective students

I am able to host a Shomer Shabbos prospective

I would bring a prospective to Hillel on Friday night

* Indicates Response Required