Hartman Teen Fellowship: Virtual Open House Registration

Looking for the Teen Fellowship Application? Click here!

Thank you for your interest in the Shalom Hartman Institute's Teen Fellowship! We are excited to offer a virtual Open House on Wednesday, March 25 @ 5:00pm PT / 8:00pm ET.

This will be an opportunity to meet and engage with Hartman Teen Fellowship staff, faculty, and current Fellows. Join us to learn more about the program, and ask pertinent questions.

After submitting your information, you will be emailed the Zoom link.

If you have any questions or concerns, please email Jesse Steinman, Manager of Teen Community & Engagement, at jesse.steinman@shalomhartman.org.

Title

First Name

Last Name

Suffix

Other Title:

Mobile:

I am a.....

What high school do you attend?

School Name

Please elaborate:

Mailing Address

Country

Provinces

City

Ontario - City

State

State/Province

Canadian Postal Code

Postal Code

US Postal Code

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:

With which Jewish denomination do you most identify?

Denomination:

Registration

I will be attending the virtual Open House on Wednesday, March 25 @ 5:00pm PT / 8:00pm ET.

Salesforce IDs for participation records

Program ID - Insert Program ID here as DEFAULT VALUE

Seminar ID - Insert Seminar ID here as DEFAULT VALUE

Geographic Region Fields - DO NOT EDIT

US Geographic Region

RegionCA1

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RegionCA3

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