Wednesday, November 20th -- 8:00pm

Temple Emanuel

395 Ward Street -- Newton, MA

Title

First Name

Last Name

Suffix

Other Title:

Mobile:

Institution / Organizational Affiliation

Position

Mailing Address

Country

Provinces

City

Ontario - City

State

State/Province

Canadian Postal Code

Postal Code

US Postal Code

OPTIONAL Demographic Information

We collect this information in order to better understand our participants and offer relevant content. This section is optional. All information is kept private and is not shared with any other entities.

Please specify your birthdate (MM/DD/YYYY):

Gender Identity

Pronouns

Gender Identity:

Pronouns:

I am a (check all that apply):

Jewish educatorClergy member

With which denomination do you most identify?

Denomination:

The Shalom Hartman Institute would like to stay in touch with you to let you know about future events and programs that might interest you. We will never sell or give your information to any other institution.

I would like to receive Shalom Hartman Institute emails.

Shalom Hartman Institute Privacy Policy

I have read the Shalom Hartman Institute Privacy Policy

Salesforce IDs for participation records

The following sections are not visible to the user filling out the form. Please insert the proper object id from Salesforce into the fields below as DEFAULT values. The object ID can be found in the URL of the salesforce entry. See the following example, the object ID is in bold.

https://hartman.lightning.force.com/lightning/r/Program_Tier_1__c/a0T7R00000aTEjiUAG/view

That string of characters needs to be added as a default value. To do so, click on the field you want to fill. Then click on the "options" button, and then enter the value into the "default values tab." See the image below for a tutorial.

Also note that you do not need to delete any fields below. For example, If you only want to create a participation for 4 classes, you can just leave the others blank.

Program ID - Insert Program ID here as DEFAULT VALUE

Seminar ID - Insert Seminar ID here as DEFAULT VALUE

Class IDs - Insert Class #IDs here as DEFAULT VALUES

Campaign ID - Insert Campaign Seminar ID here as DEFAULT VALUE

Campaign IDs - Insert Campaign Class #IDs here as DEFAULT VALUES

Geographic Region Fields - DO NOT EDIT

US Geographic Region

RegionCA1

RegionCA2

RegionCA3

RegionCA4