Atlanta 2023 10 Couples & Conversation (Malka)

Campaign ID

Today's Date

Your Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Email*

Number of adults attending*

Partner's Name*

First Name

Last Name

Partner's Email address (please provide only if different than yours)

What questions do you hope to get out of this program?

Are you in a relationship where one person identifies as Jewish and the other has a different religious or cultural background?*

Yes No

This program is intended for interfaith couples. We recommend you check our event page for other opportunities. Please reach out to event@18doors.org with any questions.

How did you hear about this event?

Search Engine Social Media Word of Mouth From Another Organization Email or e-Newsletter from 18Doors 18Doors Staff Member or Facilitator of This Event

Total Cost $

If price is a barrier to you participating in this program, please email event@18doors.org.

Credit Card*

What accommodations do you need to participate fully in this program? Please let us know about accommodations at least one week prior to the event (though we will still do our best to accommodate any requests on shorter notice). Please note that we often need 2 weeks' notice for sign language interpreters. If you need further assistance, please contact Rabbi Malka Packer-Monroe at RabbiMalka@18Doors.org

Sign up for our bi-weekly (every other week) enewsletter, as well as event and announcement emails to stay in the know!*

Yes, sign me up! No, thanks.

I would also like to receive the following emails from 18Doors (check all that apply):

Monthly Recipe Enewsletter

Jewish Holiday Email Series (emails are sent prior to each major Jewish holiday)

Wedding Email Series (7 emails about planning an interfaith wedding)

Parenting Email Series (8 emails about parenting kids aged 2-6 with Jewish values)

We sometimes take photos, audio, and video recordings to use on our website, social media, and other media outlets. Please indicate whether or not you consent to 18Doors using your image. If you have any questions please email event@18doors.org.*

I consent I do not consent

It is important that you notify the facilitator upon arrival so that they can be sure to not include you in any photographs, videos, or audio recordings. If you do not notify the facilitator we will consider this consent to use your image.