Hartman at Home

To register for upcoming Shalom Hartman Institute events, please visit:

https://www.hartman.org.il/events/

Title

First Name

Last Name

Other Title

Please make sure your email address is spelled correctly.

Country

Street Address

City

States

Province

Postal Code

Have you learned with the Shalom Hartman Institute previously?

YesNo

With which of the following groups, if any, do you identify?

Jewish Community MemberJewish Community Professional or ClergyOther Faith Community Member (Christian, Muslim, etc.)StudentInterested Other

Other Group (please specify if you'd like, though you may leave this blank):

Jewish Community Professionals and Educators

Are you a clergy member?

YesNo

I am a:

RabbiCantorRabbi/CantorRabbinical or Cantorial StudentRLI Alumnus or Current FellowOther

Primary Professional Setting:

SynagogueJewish Day SchoolCollege Campus / HillelJewish Non-ProfitCampOther:

Other Professional Setting (please specify):

I am a current fellow or alumnus of the Hartman Fellowship for Campus Professionals:

YesNo

I am a member of cohort:

RLI Cohort #

Name of School:

Anticipated year of graduation:

Organizational Affiliation:

Job Title

Student

I am a:

High School StudentUndergraduate StudentGraduate StudentRabbinical StudentOther Type of Student

Other type of student:

Name of School:

Anticipated year of graduation:

Other Faith Community Member

I am an alumnus or current fellow of the Muslim Leadership Initiative:

YesNo

MLI Cohort #

Hartman@Home programming is offered free of charge. If you would like to make a contribution to the Shalom Hartman Institute and help make this programming possible, please indicate here.

Yes, I would like to make a contribution.No, I do not want to make a contribution at this time.

Contribution

I would like to contribute the following amount:

Other Amount (please enter a number without a currency symbol):

Please indicate within which age bracket you fall:

Under 2020 - 2930 - 3940 - 4950 - 5960 - 6970 - 79Over 80Prefer not to say

With which denomination do you most identify?

ReformConservativeOrthodoxReconstructionistRenewalNon-denominationalJust JewishOther

Other Denomination: (please specify):

How did you hear about this conference?

Friend or colleagueHartman emailHartman websiteSocial mediaOther

Please describe how you heard about this conference:

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