The Blum Jewish Education Project Sign-up Form

Thank you for your interest in The Blum Jewish Education Project, fighting anti-semitism through hands on workshops.

The program is a gift to the Western New York community.

This form is to gather basic information about your group so that we can start the confirmation process with you. Please complete all required fields.

Please note that this is ONLY a request to book, not a confirmation of your booking, and all requests are subject to availability.

You will receive a confirmation of your completed booking from our Education Department within 3 – 5 business days with the subject line “The Blum Jewish Education Project Booking Confirmation”.

1. Contact Information

First Name *This question is required.

Last Name *This question is required.

Organization *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

2. Group Type: *This question is required.

Please enter an 'other' value for this selection.

3. The person above will be the group leader on the day of the visit? *This question is required.

4. Group Leader: *This question is required.

First Name

Last Name

Title

Email Address

Phone Number

In-person school groups are limited to 60 students per visit and typically, 2 tours may run at the same time. For Special Education classes, the maximum number of students is 12.

If more than 60, register for multiple days.

One chaperone must accompany every ten students; a maximum of six chaperones may accompany each class. Each classroom must be booked as a separate tour group.

4. Select grades: *This question is required.

4. How many people will be attending? *This question is required.

Total number of Students in Group
Total number of Chaperones in the group

4. How many people will be attending? *This question is required.

	Total number in group

4. What workshop are you interested in? *This question is required.

5. Workshops are conducted based on availabilty.

Please provide preferences for 3 possible dates and times. Do NOT consider your visit booked until you receive a confirmation via email from the Blum Project.

First choice date: *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

7. Second choice date: This question requires a valid date format of MM/DD/YYYY.

calendar

9. Third choice date: This question requires a valid date format of MM/DD/YYYY.

calendar

11. Please tell us anything else we should know about your requested visit or your class:
*This question is required.

12. I would like to sign up for email updates from the Blum Project. *This question is required.