SPIRIT Partner Synagogue Form

SPIRIT Partner Synagogue

Synagogue name*

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Individual Submitting form*
First Last
Email of Individual Submitting form

Title of Individual Submitting form*
First Last
Phone # of Individual Submitting form*
Name of additional person who should receive SPIRIT emails for promotion
First Last
Email additional person who should receive SPIRIT emails for promotion

Please list my synagogue as a Partner synagogue*

Yes

No
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