IKAR Registration Form
We are pleased that you are registering for Haver's IKAR class. Please fill out this registration form completely. If you are registering with a partner or spouse, please list the primary contact person (or the one considering conversion) as Adult 1 and the partner or spouse as Adult 2.

Please provide cell phones so that we can contact you with critical information. We will contact you via text for any last minute location changes or if we are canceling class because of dangerous weather conditions.

Questions? Contact Elizabeth at HaverInbox@gmail.com.

Email address *
Name of Adult 1 *
Your answer
Adult 1 - I prefer to be referred to with these pronouns:
Name of Adult 2
Your answer
Adult 2 - I prefer to be referred to with these pronouns:
Address Line 1 for Adult 1 *
Your answer
Address Line 2 (if needed) for Adult 1
Your answer
City, State, Zip for Adult 1 *
Your answer
Adult 2 - Address Line 1 if different from Adult 1
Your answer
Adult 2 - Address Line 2 (if needed/different)
Your answer
Adult 2 - City, State, Zip (if different)
Your answer
Email address for Adult 1 *
Your answer
Email address for Adult 2
Your answer
Primary Phone Number of Adult 1 *
Your answer
Cell Phone for Adult 1
Your answer
Cell Phone for Adult 2
Your answer
Do you have a sponsoring rabbi? *
If yes, who is your sponsoring rabbi?
Your answer
If you do not have a sponsoring rabbi, can we help you identify a rabbi to work with? We highly encourage you to establish a relationship with a rabbi. If you mark "yes," we will contact you.
Do you have any allergies that can be a danger to you in this class (e.g., peanuts, milk, etc.)? Please explain.
Your answer
We aim to include individuals of any age who may temporarily or permanently move, hear, see, touch, think, learn, communicate, process stimuli, or experience emotions differently. Would you like to tell us of an accommodation that would be helpful to you?
Your answer
I am sending a check, payable to Haver, to: Haver, c/o Congregation Har HaShem, 3950 Baseline Rd., Boulder CO 80303. *
Required
I am participating in this class because (check all that apply)... *
Required
I heard from about this IKAR class from: *
Your answer
Please consult with your rabbi about whether these classes are required for conversion or if they are required for your pre-marital counseling work. We do record classes, but your attendance might be required for either of these scenarios. *
Required
A copy of your responses will be emailed to the address you provided.
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