Today's Date
Name*
Mailing Address - Please note, we only ship to North America*
We are currently only offering this program to folks who are in Atlanta or Boston. Are you in the Atlanta or Boston area? If so, we'll connect you to our 18Doors Director in that area who will do a virtual mezuzah dedication with you over Zoom or FaceTime.*
If you are outside of those areas, you can still request a mezuzah but need to do it directly through the MyZuzah website. Just exit out of this form and go directly to www.myzuzah.org
Not a problem! Please sign-up to participate in a Zoom with one of our rabbis to hang your mezuzah virtually together (must be at least 3 weeks from today to allow for shipping time).
What is your age?*
How would you describe yourself?*

Almost done!

The mezuzahs sent are of the highest quality (valued at $90), so we need you to answer a few questions before we can ship your kosher, fair-trade mezuzah.

Our program provides an $90 mezuzah at no cost to you, for placement on the front door of your house or apartment. Is this mezuzah for your front door?*
MyZuzah's mission is to help place a mezuzah on every Jewish home in the world. Do you, or does someone in your household, identify as Jewish?*
18Doors’ mission is to support interfaith/intercultural families. Does your household include one partner who identifies as Jewish and another who has a different religious/cultural background?*
*If you are Jewish and not in an interfaith household, you can still request a mezuzah but need to do so directly through MyZuzah. Just exit out of this form and go directly to www.myzuzah.org
MyZuzah recipients participate in a short video call, or "Virtual Dedication," with one of our 18Doors staff to ensure a meaningful experience in putting up your mezuzah in the customary way, and then submit a picture of the dedicated mezuzah. Do you promise to select a Virtual Dedication time, and send in a photo?*
By accepting this mezuzah I understand that MyZuzah & 18Doors will have permission to use my likeness with my mezuzah in any or all digital or print media.
Sign up for our mailings and stay in the know!*
Cancel
Confirm