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Reserve your space in the 2017-18 Goodblatt Academy program!  
 Questions? Contact: Kathy Elias, Director, goodblattacademy@gmail.com, or call 732-841-4876. 
 
 

YOUR CONTACT INFORMATION

 * required
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How did you hear about this class?

How would you describe your religious background?

Do you have a spouse or significant other?

Yes
No

What is the religious affiliation of your spouse or significant other?

If you are engaged, when is your wedding date?

Do you have children?

Yes
No

At this time, do you intend to convert to Judaism?

Yes
No

Are you attending a synagogue?

Yes
No

If so, which synagogue are you attending?

If you intend to convert to Judaism, do you need help finding a sponsoring rabbi?

Yes
No

RESERVE YOUR PLACE IN CLASS

Are you applying to participate as an individual or as a couple? 

(TUITION COST: $550 for individual; $650 for couple) 

Individual
Couple

If your Jewish partner will be attending with you, please provide contact information.

Which class do you wish to attend?

Temple Beth Zion/Beth Israel, 18th Street, Philadelphia, starting October 30, 2017
Temple Beth Hillel/Beth El, Wynnewood, PA, starting October 31, 2017
Temple Beth Shalom, Cherry Hill, NJ, starting October 16, 2017
Germantown Jewish Centre, 400 Ellet Street, Philadelphia, PA, starting January 2018

PHOTO RELEASE: I agree that Goodblatt Academy may use photographs of me with or without my name, and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising and online content.

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PAYMENT OPTIONS
 
Tuition fee for an individual: $550
Tuition fee for a couple: $650 
 
You may pay in full by credit card below.
 
To pay by check/money order, or in installments, email Kathy Elias, Goodblatt Academy Director. 

Tuition for an Individual: $550

Tuition for a Couple: $650