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Goodblatt Academy 2019-20 Registration
Welcome! Fill out the form below to reserve your spot in the Goodblatt Academy for the 2019-20 year.
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Email
*
Your email
First Name
*
Your answer
Last Name
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Your answer
Phone number
*
Your answer
Address
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Your answer
City
*
Your answer
State
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Your answer
Zip Code
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Your answer
How did you hear about Goodblatt Academy?
Website
Referral from Rabbi
Referral from Friend
Newspaper
Other:
Clear selection
How would you describe your religious background?
Your answer
At this time, do you intend to convert to Judaism?
*
Yes
No
Not sure
Other:
If you intend to convert to Judaism, do you need help finding a sponsoring rabbi?
Yes
No
Clear selection
Are you engaged in any way with a synagogue community?
Yes
No
Clear selection
If you answered yes, with which synagogue community are you engaged?
Your answer
Your Jewish partner is welcome to attend classes with you. Are you applying to participate as an individual or as a couple? (TUITION COST: $550 for individual; $650 for couple)
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Individual
Couple
If your Jewish partner will be attending classes with you, please provide his/her contact information. (NAME AND EMAIL)
Your answer
Which class do you wish to attend?
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Temple Beth Sholom, 1900 Kresson Road, Cherry Hill, NJ, starting in January 2020
Germantown Jewish Centre, 400 Ellet Street, Philadelphia, PA, starting in January 2020
PHOTO RELEASE: I agree that Goodblatt Academy may use photographs of me with or without my name, and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising and online content.
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I agree
I do not agree
A copy of your responses will be emailed to the address you provided.
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