Annual Meeting Registration 2025

MailChimp Tag / Form Name

Memo

Notes to internal Federation professionals

Name*

First NameLast Name

Email*

Confirmation EmailConfirm email address

Mobile Phone Number*

Please enter a valid phone number.

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Registration is for this event is now closed and tickets can no longer be purchased.

Make a tribute to the honorees and/ or make a donation to the UJA Annual Campaign below.

Date of Birth

Tributes & Donation Options*

Honor an Award Recipient or Leadership with a Tribute Donation to the 2025 UJA Annual CampaignSelect this option and we'll send your well wishes to an honoree via email as a digital tribute card to be delivered after the Annual Meeting.

$1.00

Select Honoree	Amount $
Michele Landau - Outgoing UJA Annual Campaign Chair
Kim Hirsh - President's Bamberger Award Honoree
Emily Gantman - Cohn Young Leadership Award Recipient
Oren Henry - Cohn Young Leadership Award Recipient

Item subtotal:$0.00

Support your vibrant Jewish community A gift to our 2025 UJA Annual Campaign ensures Federation can continue to meet the dynamic needs of today, respond to crises near and far, and secure our community as a safe and welcoming place to live your Jewish life for the next century and beyond. (Pledges to the 2025 UJA Annual Campaign are payable through December 31, 2025.)

$1.00 Amount $Payment Options
Item subtotal:$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Couvert amount

Guest #1 Name*

First NameLast Name

Guest #1 Email

Confirmation Emailexample@example.com

Guest #1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Guest #2 Name*

First NameLast Name

Guest #2 Email

Confirmation Emailexample@example.com

Guest #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Guest #3 Name*

First NameLast Name

Guest #3 Email

Confirmation Emailexample@example.com

Guest #3 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Would you like to learn more about legacy giving options?*

YesNo

I understand that my picture may be taken at this event and it may appear on various channels, including social media and the Federation website.

PaymentData (ticket)

PaymentData (tribute)

PaymentData (donation)

Event appeal code

Tributes appeal code