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 *
First Name *
Last Name *
Phone number *
Address *
City *
State *
Zip Code *
How did you hear about Goodblatt Academy?
Clear selection
How would you describe your religious background?
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?
Clear selection
Are you engaged in any way with a synagogue community?
Clear selection
If you answered yes, with which synagogue community are you engaged?
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)
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.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy