Wieder Soup Squad Deliveries

Name*

First Last

Email*

Cell Phone*

UID*

Grad Year*

Jewish Affiliation:*

Do you give permission for us to reach out to your family to see how we can be of assistance?*

Yes
No

Parent Name

First Last

Parent Email

Which describes your current situation?*

Isolation (Positive Test Result)
Quarantine (Known Contact)
Non-COVID related illness

Can we share this information with the University health services for the benefit of health and safety at UMD?*

Yes
No

When did your isolation/quarantine begin?*

When does your isolation/quarantine end?*

Do you live on or off campus?*

On Campus
Off Campus

Dorm Name*

Room Number*

Off-Campus Address - If you live in an apartment building, please make sure to include your unit number.*

Street Address

Do you need kosher meals delivered to you?*

Yes
No

Are you looking for Soup Delivery?*

Yes
No

Are you on a Maryland Hillel kosher dining plan?*

Yes
No

What meal plan are you on?*

Platinum
Gold
Silver
Bronze

Breakfast Pantry Requests (cereal, milk, yogurt, granola bars)*

Which Meals?*

Monday Lunch
Monday Dinner
Tuesday Lunch
Tuesday Dinner
Wednesday Lunch
Wednesday Dinner
Thursday Lunch
Thursday Dinner
Friday Lunch

Do you need Shabbat Dinner delivered?

Yes
No

Shabbat Dinner is free for ALL UMD Students

Please enter the total number of meals you would like to order here (Not including Shabbat Dinner). *

Price: $16.99

Hidden

Please list which meals you need below

Please list and dietary restrictions or preferences below (vegetarian, gluten free, dairy free, etc.*

If possible please include the name(s) and cell phone # of someone who would be able to pick up and deliver your meals to you.

Would you like to make a donation to support Maryland Hillel?*

Yes
No

Please select the amount you would like to donate:*

Other Amount:*

3% Credit Card Processing Fee

Price: $0.00

Total

$0.00

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Wieder Soup Squad Deliveries

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