Nach Shabbat 2023 Shul Registration Form

• Name of Synagogue*
• Name of Rabbi*
  Title, first name and last name of Rabbi
• Rabbi's email address*
• Synagogue Address*
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• Name of person completing this form:*
  First Last
• Synagogue Contact Person*
  Name of person whom our department and/or the scholar can contact regarding arrangements
  First Last
• Position of contact person*
• Contact's Email Address*
• Consent*
  Upon confirmation from the OU Women's Initiative, my synagogue will submit a payment of $1250.
• Consent*
  The Rabbi or President of the Synagogue has approved the submission of this form.