Student Registration Form - Hillel at Emory

Marcus Hillel Center at Emory

CALL (404) 963-2548 for more information
Click icon for map, parking information, and directions to 735 Gatewood Rd. Atlanta, GA 30322

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First Name *
Last Name *
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Student Type *	UndergraduateGraduate Student
Expected Graduation Year *
Permanent (Parents) Home Address
Parent Name(s)
Email Address *
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Interests Check any of the following topics	BusinessConservative groupFaculty-Student DiscussionsFYSH/Freshmen ProgramsGLBT issuesGreek lifeHolocaust EducationInterfaith/Multicultural dialogueIsraelJewish learningJewish Studies ClassesMedicine/Public HealthOrthodox groupPolitical ProgramsReconstructionist groupReform groupShabbat DinnersSocial events/NetworkingSportsTraveling to Israel for the first timeI want to get back to IsraelVolunteering/Social JusticeWeekend retreatsWomen's IssuesEnvironmental IssuesLeadership Opportunities
About myself... Interests, background, etc.
Add me to the following list(s) *	Both Hillel and ChabadHillel OnlyChabad Only