WE ARE FULL!! International Shabbat Dinner 2022 for YJPS is Sold OUT!!

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Join us for our gala Ballroom Dinner: Nov 11th, 2022. Location will be sent upon paid reservation.

Guys/Girls

Reserve your spot now before this opportunity closes!

International Shabbat Dinner

What's your first name? *

What's your last name? *

What's your email? *

What's your cell? *

Do you want us to put you up for lodging/full hospitality? *

No, I do not need any lodging. Thank you for offering!

Yes, please prepare lodging. I would love to enjoy the weekend of classes and meals.

What is your level of Jewish affiliation? *

Unaffiliated

Conservative

Orthodox

Reform

What do you do? *

What is your age? *

Is your mother Jewish? *

Yes

She is a convert

Do you hear about this from a specific organization? *

Akiva Trips

EMET

Exhibit J

Saw it on Instagram

A friend told me about it

I received an email

Other:

Please pay now your $50 (non-refundable) reservation fee: BJX Payment Page (merchpay.com) *

I paid $50. Please confirm my seat at the dinner!

I added $18 more as a gift to BJX. Thank you for all that you do!

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of BJX.

Does this form look suspicious? Report