CiviCRM - ALEPH: Alliance For Jewish Renewal

SHALOM! READ ME FIRST!

Welcome to the registration for A Jewish Renewal New Year's Eve, hosted by Rabbi Geela Rayzel Raphael and friends!

This event will take place on Tuesday, December 31 at 8 pm ET (5 pm PT.)

To complete your registration, please make sure you click on the "Continue" button at the end of this form.

NOTE: Registrants to this program will have their email addresses shared with the leader who may share materials relevant to the session.

By completing this registration, you agree to the ALEPH: Alliance for Jewish Renewal Event Registration Terms and Conditions, which can be found at www.aleph.org/eventregistrationtermsandconditions.

If you have questions, please email tikshoret@aleph.org.

Thank you!

REGISTRATION FORM

How many people are you registering? *

Registrant Information

Formal Title

First Name *

Last Name *

Street Address (Home) *

City (Home) *

Postal Code (Home) *

Country (Home) *

State (Home)

Province (non US)

Email (Primary) *

Preferred/best phone *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *