*Free Trip to Poland! March 16, 2020 (ages 20-36)
The Trip of a Lifetime! *Deposit (non refundable) $650. This 7 day trip (March 16-22) costs close to $2,500
Full Name
*
First Name
Last Name
Cell Number (This is kept confidential.)
*
Format: (000) 000-0000.
E-mail (We do not share this info)
*
Which High Schools and Colleges have you attended? (Please list all)
*
What is your profession?
How would you describe your Jewish affiliation
*
Unaffiliated
Reform
Orthodox
Conservative
What's your age?
*
Is your Mother Jewish
*
Yes, by conversion
No
Yes, she was born Jewish
Which other Jewish Trips have you been on? Please list all organizations/ trips
*
How did you hear about us?
*
Google
FB
Email
Other
I certify that all information I provided is 100% accurate.
*
Yes, it is all 100% accurate.
No.
I understand that to qualify for this very reduced trip, I will be required to attend 2 hours sessions of Jewish study for 5 consecutive Sundays at our Midwood location.
*
Yes, thank you for this opportunity!
No thanks, I would rather pay the full price.
Submit
Should be Empty: