Student Info Form
Want to find out about Jewish Life on Campus?
Need to update your contact info?
Hillel will provide you info about Jewish campus events and holiday programs via our e-newsletter and campus mailings.
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First Name
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Last Name
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What University do you attend?
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Class of
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Undergrad or Grad?
Undergraduate Student
Graduate Student
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Email
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Cell/local Phone
Campus Box#
Local Address
Address Line 2
City
State
Alabama
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California
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Delaware
Florida
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Hawaii
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Kentucky
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Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Date of Birth
Major
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Permanent Home Address
Address Line 2
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City
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State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
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Zip Code
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Home Phone or Parent Cell
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Parent(s) Name(s)
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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
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Indicates Response Required