Mini-Course Registration Form

1. PROGRAM APPLICATION

Thank you for registering for the Rodef Shalom Mini-Course












2. PERSONAL DETAILS






MM/DD/YY




3. CONTACT INFORMATION

Please include full dialing codes










DD/MM/YY







4. EDUCATIONAL & PROFESSIONAL EXPERIENCE







MM/YY

MM/YY

Please add extra institutions or educational details here.


Work, student, homemaker, etc.


MM/YY

MM/YY
5. JEWISH AND CONFLICT RESOLUTION INVOLVEMENT Please complete all relevant sections























6. HOW DID YOU HEAR ABOUT THE MINI-COURSE?
We appreciate your specificity, both to help us in our recruitment, and so that we can say thank you.








7. PAYMENT

Please make your program payment. Your application cannot be processed without payment. 

If you are registering for the course at the Moishe Kavod House in Boston, you can either pay online or bring a check made out to Moishe Kavod House when you come for the first class, or to get in touch with helen@kavodhouse.com about scholarship.

POB 8575, Jerusalem 9108402 Israel | T +972 2 673 5210 | F +972 2 673 5160 | info@pardes.org.il
228 Park Ave S Suite 35858 New York, New York 10003-1502 | T +1 212 447 4333 | F +1 212 447 4315 |
info@pardes.org
www.pardes.org.il