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Registration

To purchase your Kosher Meal Plan or Discover Hillel Card and pay online, please complete the following registration form.

Student Information
First Name
A value is required.
Last Name
A value is required.		 Student ID #
A value is required.
Must be 10 Digit
Must be 10 digits.
School Address
A value is required.
City
A value is required. State
Value Required		 Zip
A value is required.
Invalid format.
Permanent Address
A value is required.
City

A value is required.		 State
Value Required.		 Zip
A value is required.
Invalid format.
Phone Number
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Cell Phone
A value is required.		    
E-mail Address
A value is requiredInvalid format.		      

Family Information
Father's
Name 		Mother's
Name 		   
Father's Address City State Zip
Mother's Address City State Zip
E-mail Address        
     
 

730 East Third Street | Bloomington, IN 47401 | (812) 336-3824 | hillel@indiana.edu

The programs Hillel offers are made possible thru generous gifts from our families, friends, and the following Federations:
Indianapolis | Cincinnati | Akron | Cleveland | Columbus | Dayton | Toledo | Youngstown
Fort Wayne | Northwest Indiana | South Bend | Louisville
Jewish Foundation of Greater Indiana | Hillel International