JRF College Student Database Survey

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1. Before we can get started we need some information about you: College contact information

Before we can get started we need some information about you: College contact information Name:
College:
College Address:
College Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
College Email Address:
Cell Phone Number

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2. Home Information

Home Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Phone Number:

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3. What is the best way to contact you?

What is the best way to contact you? Email

Phone

Mail

Other

Other (please specify)

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4. What is your estimated year of graduation from College

What is your estimated year of graduation from College '10

'11

'12

'13

'14

'15

Other (please specify)

5. Are you affiliated with your campuses Hillel or Jewish Student Union?

Are you affiliated with your campuses Hillel or Jewish Student Union? Yes

No

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6. What is your home congregation?

	Home Congregation
Please choose your home congregation, if you do not see your synagogue please select other and be specific about your congregations name.	What is your home congregation? Please choose your home congregation, if you do not see your synagogue please select other and be specific about your congregations name. Home Congregation

Other (please specify)

7. Are you aware of any Reconstructionist congregations and/or Rabbis within your area?

Are you aware of any Reconstructionist congregations and/or Rabbis within your area? No

Yes. If yes, who or what is the name of the person/place?

8. Please select the following Jewish Youth Groups you were affiliated with:

Please select the following Jewish Youth Groups you were affiliated with: BBYO

Habonim

NFTY

No’ar Hadash

USY

Young Judaea

I did not belong to a youth movement

Other

9. Have you ever attended Jewish overnight camp? If so, please provide the camp name and the years you attended.

Have you ever attended Jewish overnight camp? If so, please provide the camp name and the years you attended. No

Yes

10. Would you like to help spread the word about JRF's project, sign your friends up for our database.

Would you like to help spread the word about JRF's project, sign your friends up for our database. Name (First Name Last Name):
Email Address:
Name (First Name Last Name):
Email Address:
Name (First Name Last Name):
Email Address:
Name (First Name Last Name):
Email Address:
Name (First Name Last Name):
Email Address:

JRF College Student Database
Exit this survey

1. Default Section

*
1. Before we can get started we need some information about you: College contact information

*
2. Home Information

*
3. What is the best way to contact you?

*
4. What is your estimated year of graduation from College

5. Are you affiliated with your campuses Hillel or Jewish Student Union?

*
6. What is your home congregation?

7. Are you aware of any Reconstructionist congregations and/or Rabbis within your area?

8. Please select the following Jewish Youth Groups you were affiliated with:

9. Have you ever attended Jewish overnight camp? If so, please provide the camp name and the years you attended.

10. Would you like to help spread the word about JRF's project, sign your friends up for our database.

JRF College Student DatabaseExit this survey

1. Default Section

*1. Before we can get started we need some information about you: College contact information

*2. Home Information

*3. What is the best way to contact you?

*4. What is your estimated year of graduation from College

5. Are you affiliated with your campuses Hillel or Jewish Student Union?

*6. What is your home congregation?

7. Are you aware of any Reconstructionist congregations and/or Rabbis within your area?

8. Please select the following Jewish Youth Groups you were affiliated with:

9. Have you ever attended Jewish overnight camp? If so, please provide the camp name and the years you attended.

10. Would you like to help spread the word about JRF's project, sign your friends up for our database.

JRF College Student Database
Exit this survey

*
1. Before we can get started we need some information about you: College contact information

*
2. Home Information

*
3. What is the best way to contact you?

*
4. What is your estimated year of graduation from College

*
6. What is your home congregation?