Living Links Application Spring 2022

LivingLinks Application Winter 2023 & Spring 2024
Apply for one of our upcoming LivingLinks trips. Select your preferred date below. Please note: All trips depart from NYC unless otherwise noted.*

December 24 - 31, 2023March 10 - 17, 2024
Student Information
Full Name*

First NameLast Name
Email*
example@example.com
Cell Phone Number*

Area CodePhone Number
Gender*

FemaleMale
Date of Birth*

MonthDayYear
Date
University*
If you do not see your university is listed, please select other.
Graduating Year*
My Chabad on Campus is run by Rabbi and Mrs. ...*
Who is your campus Rabbi or Rebbetzin?
Home State*
Have you previously participated in a trip to Poland?*

YesNo
If yes, please explain:
Do you have any allergies or dietary restrictions*

YesNo
If yes, please explain:
Do you have any medical conditions we should know about for the trip?*

YesNo
If yes, please explain:
Are you currently taking any medication?*

YesNo
If yes, please explain:
Are you currently seeing a psychologist or psychiatrist?*

YesNo
If yes, please explain:*
Jewish Family Background
Mother*

Born JewishConverted to JudaismOther
Father*

Born JewishConverted to JudaismOther
Jewish Education (check all that apply)*

Hebrew SchoolSummer CampJewish Day SchoolBar/Bat MitzvahJewish High SchoolNone of the above
How did you hear about the trip? (check all that apply)*

Chabad Rabbi/RebbetzinSocial MediaFriends and FamilyOther
Please tell us about your current Jewish campus involvement:*
In two paragraphs or more describe why you want to join this trip and what you hope to gain from it?*

0/0
Is there anything else we should know about you or your application?
I understand that I must have a passport valid for at least 6 months from the last day of the trip.*

Confirm
I understand that Chabad on Campus may contact me for my valuable feedback as a LivingLinks participant.*

Confirm
I would like to receive information about Jewish post-graduate opportunities offered by Chabad on Campus funding partners.*

Yes, pleaseNo, thank you
Should be Empty:

LivingLinks Application Winter 2023 & Spring 2024