Goodblatt Academy 2019-20 Registration
Welcome! Fill out the form below to reserve your spot in the Goodblatt Academy for the 2019-20 year.
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone number *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
How did you hear about Goodblatt Academy?
How would you describe your religious background?
Your answer
At this time, do you intend to convert to Judaism? *
If you intend to convert to Judaism, do you need help finding a sponsoring rabbi?
Are you engaged in any way with a synagogue community?
If you answered yes, with which synagogue community are you engaged?
Your answer
Your Jewish partner is welcome to attend classes with you. Are you applying to participate as an individual or as a couple? (TUITION COST: $550 for individual; $650 for couple) *
If your Jewish partner will be attending classes with you, please provide his/her contact information. (NAME AND EMAIL)
Your answer
Which class do you wish to attend? *
PHOTO RELEASE: I agree that Goodblatt Academy may use photographs of me with or without my name, and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising and online content. *
A copy of your responses will be emailed to the address you provided.
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