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Notes to internal Federation professionals
Appeal code
The lead admin must provide this for any form in which a donation may be made either in addition to or part of a registration fee
LGBTQ+ Pride Shabbat Kits Registration
Please register below to get your FREE LGBTQ+ Pride Shabbat kit! This kit has everything you’ll need to celebrate LGBTQ+ Pride Shabbat in your own home on any Friday in June.
First Name
*
Last Name
*
Email
*
Confirmation Email
Confirm email address
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mailing Address
*
Street Address
Street Address Line 2
City
Please Select
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State
Zip Code
Birthdate
*
-
Month
-
Day
Year
Date
I am affiliated with a synagogue or agency and would like more than one kit for my members/clients*
*Someone will reach out to you to confirm numbers and pick-up options.
Please select the number of people you are registering including yourself
*
Please Select
1
2
3
4
5
Additional Participant #1 First Name
*
Additional Participant #1 Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Participant #2 First Name
*
Additional Participant #2 Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Participant #3 First Name
*
Additional Participant #3 Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Participant #4 First Name
*
Additional Participant #4 Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I will pick up my Pride Shabbat Kit on the following day/location:
*
Monday, June 1 in Whippany (9 a.m.-5 p.m.)
Tuesday, June 2 in Whippany (9 a.m.-5 p.m.)
Thursday, June 4 in Whippany (9 a.m.-5 p.m.)
Sunday, June 7 at Livingston Pride Celebration (12-4 p.m.)
Sunday, June 14 at North Jersey Pride (12-5 p.m.)
Saturday, August 1 at Montclair Pride (12-5 p.m.)
None of these options work for me. I will reach out to Sharon Zucker at szucker@jfedgmw.org to make alternative arrangements.
Please confirm the name of the person picking up your Pride Shabbat Kit
*
Federation event participants will receive a name tag upon arrival (children under 18 will have first names only). If you or any registered guests prefer a different name than what has been provided above, please enter it below.
How did you hear about this event? (check all that apply)
Print invitation
Email invitation
Print advertisement
Social media
Word of mouth
Federation 5
I understand that my/our picture may be taken at this event and it may appear on various channels, including social media and the Federation website.
Please complete the CAPTCHA below
*
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