Poland+Israel

Poland+Israel Mission Registration

"*" indicates required fields

Name*

Title First Middle Last

Name as you would like it on name tag*

Birthdate*

Do you hold an Israeli passport?*

Yes

Email*

Cell Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mission Selection

Please Select Your Mission*

Mission to Poland+Israel

Mission to Poland

If you're interested in the Mission to Israel only, please contact Jordan Tal at jtal@jfedpgh.org or 412-992-5227.

Are you in a single or double occupancy room?*

I am sharing a double occupancy room.

I request a single occupancy room.

Mission to Poland Room Request*

$3,499 per person based on double occupancy.

$2,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland Room Request*

$4,349 per person. (includes $850/person supplement)

$3,849 per young adult (ages 22-45 at the time of the mission). (includes $850/person supplement)

Mission to Poland+Israel Room Request*

$6,999 per person based on double occupancy.

$5,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland+Israel Room Request*

$8,699 per person. (includes $1,700/person supplement)

$7,699 per young adult (ages 22-45 at the time of the mission). (includes $1,700/person supplement)

Roommate's Name*

Bed Type*

One Bed

Separate Beds

Additional Participants

Are you registering a second participant?

Yes

Participant 2*

Title First Middle Last

Name as you would like it on name tag*

Birthdate*

Does this person hold an Israeli passport?*

Yes

Email*

Cell Phone*

Address Choice*

Same as above

Enter different address

Address Participant 2*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mission Selection for Participant 2*

Mission to Poland+Israel

Mission to Poland

If you're interested in the Mission to Israel only, please contact Jordan Tal at jtal@jfedpgh.org or 412-992-5227.

Is Participant 2 in a single or double occupancy room?*

I am sharing a double occupancy room.

I request a single occupancy room.

Mission to Poland Room Request*

$3,499 per person based on double occupancy.

$2,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland Room Request*

$4,349 per person. (includes $850/person supplement)

$3,849 per young adult (ages 22-45 at the time of the mission). (includes $850/person supplement)

Mission to Poland+Israel Room Request*

$6,999 per person based on double occupancy.

$5,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland+Israel Room Request*

$8,699 per person. (includes $1,700/person supplement)

$7,699 per young adult (ages 22-45 at the time of the mission). (includes $1,700/person supplement)

Participant 2's Roommate's Name*

Participant 2's Bed Type*

One Bed

Separate Beds

Are you registering a third participant?

Yes

Participant 3*

Title First Middle Last

Name as you would like it on name tag*

Birthdate*

Does this person hold an Israeli passport?*

Yes

Email*

Cell Phone*

Address Choice*

Same as above

Enter different address

Address Participant 3*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mission Selector for Participant 3*

Mission to Poland+Israel

Mission to Poland

If you're interested in the Mission to Israel only, please contact Jordan Tal at jtal@jfedpgh.org or 412-992-5227.

Is Participant 3 in a single or double occupancy room?*

I am sharing a double occupancy room.

I request a single occupancy room.

Mission to Poland Room Request*

$3,499 per person based on double occupancy.

$2,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland Room Request*

$4,349 per person. (includes $850/person supplement)

$3,849 per young adult (ages 22-45 at the time of the mission). (includes $850/person supplement)

Mission to Poland+Israel Room Request*

$6,999 per person based on double occupancy.

$5,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland+Israel Room Request*

$8,699 per person. (includes $1,700/person supplement)

$7,699 per young adult (ages 22-45 at the time of the mission). (includes $1,700/person supplement)

Participant 3's Roommate's Name*

Participant 3's Bed Type*

One Bed

Separate Beds

Are you registering a fourth participant?

Yes

Participant 4*

Title First Middle Last

Name as you would like it on name tag*

Birthdate*

Does this person hold an Israeli passport?*

Yes

Email*

Cell Phone*

Address Choice*

Same as above

Enter different address

Address Participant 4*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mission Selector for Participant 4*

Mission to Poland+Israel

Mission to Poland

If you're interested in the Mission to Israel only, please contact Jordan Tal at jtal@jfedpgh.org or 412-992-5227.

Is Participant 4 in a single or double occupancy room?*

I am sharing a double occupancy room.

I request a single occupancy room.

Mission to Poland Room Request*

$3,499 per person based on double occupancy.

$2,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland Room Request*

$4,349 per person. (includes $850/person supplement)

$3,849 per young adult (ages 22-45 at the time of the mission). (includes $850/person supplement)

Mission to Poland+Israel Room Request*

$6,999 per person based on double occupancy.

$5,999 per young adult (ages 22-45 at the time of the mission) based on double occupancy.

Mission to Poland+Israel Room Request*

$8,699 per person. (includes $1,700/person supplement)

$7,699 per young adult (ages 22-45 at the time of the mission). (includes $1,700/person supplement)

Participant 4's Roommate's Name*

Participant 4's Bed Type*

One Bed

Separate Beds

Agreement Information

Campaign Participation Agreement*

I (We) understand that participation in this Mission requires a minimum commitment of $3,600 each year to the 2025 and 2026 Federation Community Campaigns (or $1,000 for young adults ages 22-45 at the time of the Mission).

Yes, I (we) agree.

Photo Release and Liability Agreement*

By registering for this event, you agree that your (and your guest's) picture and/or video may be taken and potentially used in Jewish Federation marketing material and social media.

Yes, I (we) agree.

Insurance Recommendation*

I (We) understand it is expressly recommended that I review my personal insurance coverage needs with my insurance advisors to determine if additional travel insurance is required providing for reimbursement for trip delay, missed connections, sickness and accident, medical expenses, lost baggage, personal effects, baggage delay, etc.

Yes, I (we) agree.

Payment Information

When you submit your registration, you will be redirected to a payment form. You may simply pay your $500 per person deposit at this time, or any additional amount.

Your Total

Phone

This field is for validation purposes and should be left unchanged.

Support Civilian Victims of the Terror Attack in Israel

Poland+Israel Mission Registration

Mission Selection

Additional Participants

Agreement Information

Payment Information

More Information

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