Welcome to the Chabad of Binghamton Family! Please read through this form carefully and make sure to fill it out accurately. Please note: Some sections will expand to ask for additional information once you check the box indicating you want to participate. Sections include: The New Student Welcome Package Early Campus Move-In (The option to move in early is closed) The Freshman Shabbaton Shabbat Key Application Full Name* First Name Last Name E-mail* Phone Number* New Student Welcome KitWe'd love to send you a welcome package with some swag, lots of helpful information about what we offer, and much more. Home Address* Home City* Home State* Home Zip Code* Will your Parents be joining the move in Bagel Brunch? From 11am - 3pm Thursday and from 11am - 1pm Friday in the Dickinson lounge Yes - Thurdsay from 11:00 am to 3:00 pmYes - Friday from 11:00 am - to 1:00 pmNo Freshmen and Transfer ShabbatonEnjoy a fun and meaningful Shabbat experience! August 14-15 @ Chabad. Would you like to join our Freshmen and Transfer Shabbaton?* Yes I will be joining the Shabbaton.No I will not be joining the Shabbaton. Meals* Friday Dinner 7:30 PM (services at 6:30 pm)Saturday Lunch 12:00 PMSeuda Shlishit and Havdalah Blessings (Begins 7:15pm) Parent/Gardian* First Name Last Name Parent/Gardian contact number* Shabbat KeyFor Shabbat observant students to obtain a manual key to use on Shabbat and holidays instead of the electronic key card to access their dorms,the Res Life Community office will request a letter from Chabad for this purpose. Fill out the following form to have a letter sent to your RA (for forms submitted past 2:30pm letters will be sent the following day). Shabbat Key Shabbat key Shabbat Key information Preferred Name* BU Housing Community* BU Dorm Building* Room number* BU Student ID number* What date will you be moving in? August 12thAugust 13thAugust 14th What time will you be checking in? 9:00 AM10:00 AM11:00 AM12:00 PM1:00 PM2:00 PM3:00 PM I would like to donate to Chabad $100$360$500 Payment Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country I would like to receive news and updates by email Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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