Hinenu | Israeli Reform Movement Biennial

Tickets

Are you coming alone or with a partner?

* Ticket type

Friday and Shabbat at the IMPJ VEIDA 360$

Two Tickets - Friday and Shabbat at the IMPJ VEIDA 720$

Friday - First and major day at the IMPJ VEIDA 250$

Shabbat at the IMPJ VEIDA 110$

Two Tickets - Friday - First and major day at the IMPJ VEIDA 500$

Two Tickets - Shabbat at the IMPJ VEIDA 220$

Personal Information

Prefix

* First Name

* Last Name

* Congregation

* Address

* State / Province

* Country

* Phone

* Email Address

I approve sending verifications, instructions, and other messages related to the conference to the email address and phone number I have provided.

I would like to receive IMPJ's English newsletter.

I would like the hotel to contact me about overnight accommodation

Yes No

Food preferences

* Please choose

No preferencesVegetarianVeganOther

* Please specify | Other

Partner's Personal Information

Partner Prefix

* Partner First Name

* Partner Last Name

* Partner Phone

* Partner's Email Address

* Please specify | Other

Partners Food preferences

* Please choose

No preferencesVegetarianVeganOther

* Please specify | Other

Purchase a ticket for an Israeli soldier or young adult

Would you like to purchase a ticket for an Israeli soldier or young adult that does not have the financial means to pay for his/her ticket?

Cost of one ticket 180 $

Yes! I'd like to purchase a ticket

Maybe next time

* Number of donated tickets

Payment

Item	Subtotal
Subtotal	Subtotal	$
Discount
Total	Total	$

Total Amount

$0.00

* Payment Method

I agree to make out a check

After submitting the form you will be redirected to a secure website to perform the transaction. Only after doing so will your registration be completed.

Invoice/Receipt Information

* Email address for invoice/receipt

* Name for invoice/receipt

* Institute Name

* Institute Number

* Institute's accounting contact

* Institute's accounting phone

* Institute's billing address

I agree to make a bank transfer of the aforementioned amount

After submitting the form you will be redirected to PayPal to confirm the transaction. Only after doing so will your registration be completed.

Invitation code

In order to verify that you were invited, please fill in the code you recieved when invited

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