elluminate · JWFNY Convening 2022 - Registration/Payment by Check

Contact Information

Name

*

First Name

Last Name

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email

*

Verify Email

*

Phone Number

Sometimes we like to call instead of email - please share your most reliable phone number!

Guests

If you are planning to purchase tickets for more than yourself, please provide your guests' names and email addresses so we can be in touch with them for registration purposes.

How do you plan to attend The Convening 2022?

*

In Person!

Online!

Dietary Restrictions

Please share any dietary requirements below. Note that all food at the JWFNY Convening will be dairy/vegetarian.

Dairy-free

Gluten-free

Certified Kosher

Vegan

N/A

Event Swag

Yes, I would like event swag.

No, please do not send event swag.

Do you need any special accommodations to fully participate in The Convening?

*

Yes, please contact me for more details.

No, thank you.

How did you learn about the JWFNY Convening?

JWFNY Email

A friend/colleague/family member

Social media

Nonprofit partner

Other

Please share the name of your friend, family member, or colleague.

Comments/Questions?