BJE Adult March of the Living 2024 Preliminary Application

BJE Adult March of the Living 2024 Preliminary Application

Please fill in the form below for the first person you would like to register. If you would like to register an additional participant, please click on "Click to Add an Additional Participant" at the bottom right and fill in the form once again. Please indicate the total number of participants in the bottom box.

To complete your application, you will need to submit a $500/person fully refundable deposit. After filling out the form below, you can mail a check to BJE Adult March of the Living, 6505 Wilshire Blvd. #300, Los Angeles, CA 90048, or press the button at the bottom left "CLICK HERE to submit registration and pay via PayPal" to make a credit card payment through PayPal. Please note that you do not need a PayPal account to pay through the PayPal system.

PASSPORT INFORMATION:

Your passport must be valid for at least 6 months after your return to the United States.
FOR ISRAELI CITIZENS: If you were born in Israel, you must also possess an Israeli passport (valid for at least 6 months after your return to the United States).
Please mail a legible copy of the front page of your passport(s) to BJE Adult March of the Living, 6505 Wilshire Blvd. #300, Los Angeles, CA 90048.

For questions or further information, call Miriam Prum Hess at 323.761.8334

Please fill out one form per registrant. Select Click to Add an Additional Participant on bottom right for second application.

Participant Information

FULL NAME AS IT APPEARS ON YOUR PASSPORT:

NAME as you would like it on name tag:

EMAIL ADDRESS:

HOME PHONE NUMBER:

BUSINESS PHONE NUMBER:

CELL PHONE NUMBER:

ADDRESS:

TRAVELING WITH (IF APPLICABLE):

I AM INTERESTED IN:

Poland and Israel May 3-15, 2024Poland only May 3-9, 2024Israel only May 9-15, 2024

Total numbers of participants:

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