Honeymoon Israel BTH Registration

Your Name*

First

Last

Your Pronouns

Your Email*

Partner's Name*

First

Last

Partner's Pronouns

Partner's Email*

How do you describe your relationship? (Married, engaged, partnered, etc.)*

If you are married, when was your wedding?

If you are engaged, when is your wedding date?

Is there anything else you would like the facilitators to know about your relationship?

Identity Information

The identity questions below will be used to advance our diversity, equity, and inclusion goals, to learn more about our community, and to measure the impact our programs are having on the broader Jewish community. As a non-profit organization, at times our funders are interested in this information as well.

How do you describe your ethnic identity (Ashkenazi, Sephardi, Mizrahi, etc.)?

How does your partner describe their ethnic identity (Ashkenazi, Sephardi, Mizrahi, etc.)?

Do you identify as a member of the LGBTQ+ community?

Yes
No
Prefer not to answer

Does your partner identify as a member of the LGBTQ+ community?

Yes
No
Prefer not to answer

Do you identify as having a visible or invisible disability?

Yes
No
Prefer not to answer

Does your partner identify as having a visible or invisible disability?

Yes
No
Prefer not to answer

Do you identify as Black, Indigenous, or a Jew of Color?

Yes
No
Prefer not to answer

Does your partner identify as Black, Indigenous, or a Jew of Color?

Yes
No
Prefer not to answer

Is there anything about you or your partner's identities that you would like us to know?

Payment Information

As part of our commitment to petichut, openness, this class is on a sliding scale. Please register at the price point that is sustainable for your needs.

How much would you like to contribute to registration?*

Registration Total*

Price: $0.00

Credit Card

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Card Number

Expiration Date

Security Code

Cardholder Name

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