Jewish Perspectives on The Death with Dignity Act
An afternoon of learning cosponsored by The Board Of Rabbis of Southern Nevada, The Jewish Federation of Las Vegas and Touro University.
Please fill out this form entirely. You will need to fill out one form for each person attending the event. The printout will be automatically forwarded to the email you provide right after you complete the form. Please bring your id with you.
First Name
*
Last Name
*
Age
*
Street
*
City
*
State
*
Zip Code
*
Phone Number
*
Congregational Affiliation
*
MKT
TBS
CNT
PneiT
Sinai
CHBD
Kollel
BKB
YI
No Afilliation
email (required for confirmation printout)
*
Security Code
*