YA Shabbaton

Shabbaton Registration

* Indicates required field

Name *

First

Last

Phone number *

Email *

The JSN will be providing housing and meals.

Are you a vegetarian? *

Yes No

Do you have any dietary restrictions? If so, please specify. *

Do you require overnight accomodations? *

Yes No

What is your gender? *

Male Female

What is your age? *

21-25 26-35 36-45

Questions or comments? *

Submit