PRELIMINARY APPLICATION FORM

PLEASE NOTE:
This is not a registration link; it is a preliminary application to determine registration status. You will be contacted in order to register. If you dont hear from us within a week, please contact us by email: retreat@jinspire.org
Personal Information
First Name: *
Last Name: *
City: *
State: *
Country: *
Cell Number: *
Email Address: *
Gender: *
Male     Female
Application Information
How did you hear about this event? *
What is your Jewish affiliation? *
Have you gone on a JWRP trip? *
   
Are you coming with a particular JInspire group? *
   
How many people are you attending with? *
Please list names
Additional Comments:
Subsidies are available for adults or adults and children sharing 1 room.

Only enter this field if you were told to do so by a staff member.
For questions, email retreat@jinspire.org or call (646) 461-3314.
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