Reshet Ramah Poland Trip: Non-Binding Registration Form

Full Name*

First NameLast Name

Pronouns

Date of birth*

Date

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Have you attended or worked at a Ramah camp or program?*

YesNo

Please select any Ramah camps or programs with which you are affiliated.*

Dietary needs*

What is your professional industry/ graduate school? If you hold any lay leadership roles in your community, please indicate that as well. *

In order to travel outside of the United States, one needs a passport that is valid for at least 6 months. Does your passport expire before November 19, 2024?

NoYes, and I will explore options for obtaining a new passport before this trip.

Anticipated costs for this trip are $1500-$1700 plus airfare. If cost is an obstacle, please let us know approximately how much financial assistance you will require.

Is there anything else you would like to add?

Ha'Dor Yizkor: Reshet Ramah Poland Journey Non-Binding Registration Form

Ha'Dor Yizkor: Reshet Ramah Poland Journey Non-Binding Registration Form