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Clip & Mail this form to: PETER MATUSOW, Registrar 49 Westlake Road Natick, MA 01760 Make checks payable to "NER-FJMC SIGN ME UP! (Please print) Name ________________________________________ Address ______________________________________ City _________________________________________ State _____ZIP ________________________________ Congregation __________________________________ Leadership Positions List office, if any: ___________________________ Name to appear on Badge: _______________________ Email ________________________________________ Phone _______________________________________ Occupation ___________________________________ No price increase over last year! Discount rate (Paid in full by May 15) $270 Regular rate (Min. $25 to reserve by May 15) $300 Sponsor (Min. $25 to reserve by May 15) $350 Patron (includes $50 to Tikvah Fund; send in $25 to reserve by May 15) $400 First-timer rate (no cut-off date) $200
Special rate for men 21 to 30 years old. $185 ACCOMMODATIONS:
[ ] Regular Bunk [ ] Guest House ( Additional $55 pp, dbl. occ. ) [ ] Quiet Area Single Room ( No additional cost ) SPECIAL DIET: [ ] Vegetarian meals HONORS: [ ] Aliyah [ ] Other_______________ [ ] Read Torah [ ] Read Haftorah [ ] Lead Services________________________ |
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