Mikveh Guide Training Registration
 
*Email address:
Secondary Email address:
Title:
*First name:
*Last name:
Suffix:
*Gender:
Profession:
*Name as it will appear on your badge:
*Home phone number:
*Work phone number:   Extension:
Mobile phone:
Home address:
Home city:
Home state:
Home zip code:
Home country:
Attach photo:
*Primary contact address:
*Congregation/Organization:
*Congregation/Organization Address line 1:
Congregation/Organization Address line 2:
*Congregation/Organization City:
US State/Canadian Province:
*Zip/Postal Code:
Country:

Special Needs:
I have impaired mobility
I need an ASL interpreter
I have a medical condition requiring a special diet
(note: all food will be kosher, vegetarian)


Additional Session For Professionals Supporting Volunteer
Mikveh Guides
I am interested in attending an additional session for professionals supporting mikveh guides. The session will be held on Tuesday, Nov. 18 from 1-4 pm.


Accommodations:

We have reserved hotel a block of rooms at a discounted rate of $159.00 at the Newton Marriott, which is approximately 1.7 miles to Mayyim Hayyim.  Transportation will be provided between the hotel and Mayyim Hayyim at the beginning and end of each day of training.

Please make reservations directly with the hotel no later than October 26, 2008. 

  • For accommodations, please contact the Newton Marriott Hotel, 2345 Commonwealth Avenue, Newton MA 02466.  Please ask for the Mayyim Hayyim Conference room block, reference # 1-RSJYZ5.

-Via telephone 1 (800) 468-3571 or 617-969-1000
-Online  www.marriott.com

Lunch and dinner on Sunday and Monday, as well as lunch on Tuesday will be provided.  Dietary laws will be observed.


Conference Fees:

Fees are $195 per participant or $136 per participant if two or more people from the same community attend. Please select one of the following options:

I wish to register at the regular rate of $195.00 per participant

Two or more individuals from my community are attending, and we will each register separately for $136.00. Names of other attendees:


Payment:

Please select how you wish to pay for your registration:

Pay online through our secure server (recommended)

Pay offline, by check