Chicken Soup Care Bag REQUEST

Parents Address*

Birthdate*

Month Day Year
Graduation Year*
Major/Degree:*
I am a:*

UF StudentUF Grad StudentSFC StudentUF Alumnus
Are you Jewish?* Check all that apply

YesNoMy Mother is JewishMy Father is JewishConverted
Fraternity/Sorority:*
Parents Info:
Father’s Name*

First Name Last Name
Father’s E-mail*
Father’s Phone*

Area Code Phone Number
Mother’s Name*

First Name Last Name
Mother’s Phone *

Area Code Phone Number
Mother’s E-mail*
PICKUP/DELIVERY INFO
Pickup/Delivery*

I or a friend will pick up my Soup Care Bag from Chabad UF (Quickest)Please deliver my soup my Soup Care Bag to the following address
Please include:
- Name of dorm or apartment complex
- Ideal delivery date/day and time
Delivery Address
Comments or questions:
Donation Info (Optional)
Chicken Soup Care Bag is a free service provided by Chabad UF for students at UF & SFC that are not feeling well.

Please consider making a donation now to help us continue our vital work!
Donation Amount

$5000$2500$1800$1000$500$360$180$100

Payment

Credit Card Paypal Check/Venmo/CashApp/Zelle

Postal / Zip Code

Country

Please mail your check to: Lubavitch Chabad Jewish Center, 2021 NW 5th Ave. Gainesville, FL 32603
Should be Empty:

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Student Info