Name:

Address for 2007-2008 school year:

Campus Phone Number for 2007-2008 school year:

Home Address:

Home City: State: Zip:

Current Campus Address:

Current Campus Phone:

Mother's Name:
MU Alumna? Yes No
Address if different from yours:

Father's Name:
MU Alumnus? Yes No
Address if different from yours:

Date of Birth (mm/dd/yyyy):

Expected Graduation 20

Major:

Fraternity or Sorority (please indicate):

Preferred Email:

Cell Phone:

TELL US ABOUT YOU:

I am...
Reform
Orthodox
Secular
Conservative
Reconstructionist
Just Jewish

Check all that apply!
I can lead Friday night services
I can chant Torah: Haftorah:
I can blow Shofar
I can read Hebrew well
I have had a Bar/Bar Mitzvah
I have been to Israel times
I have been in a Jewish youth group:
BBYO USY NCSY NFTY Other

What interests you? Check all that apply!
Social Events
Israel
Women's Group
Participating in High Holiday Services
Community Service
Cultural Programming
Jewish Education Classes
Holiday Celebrations
Intramural Sports
Jewish/Greek Programming
Having a Bar/Bar Mitzvah
Holocaust awareness
Other:

Interested in Volunteering? Yes No
Interested in a Leadership Role? Yes No