Registration Form - Amitim 2.0 Conference

The "Amitim 2.0 Fellows – A Global Leadership Network" conference will be held in New York, from Sunday, November 5th until Thursday, November 9th, 2017.

The conference will take place at the DoubleTree by Hilton Hotel in Tarrytown, New York on a half board basis.

A welcoming ceremony will be held on Sunday night, November 5, at 8:00 PM. The opening plenary will begin at the hotel on Monday, November 6, at 9:00 AM. We ask that all Fellows stay overnight at the hotel on Sunday night, November 5.

For your information, we will provide a bus from/to the airport, and from/to Manhattan Grand Central Terminal, on Nov. 5 and Nov. 9. We will update you once specific timings are set.

To view a draft of the conference program, please click here.

* Mandatory field

Personal Information

I am a*
Category*
Title*
First Name*
Last Name*
Name of JCC (Organization)*
Professional Title (Role at JCC)*
Mailing Address (Home/Business)*
City*
State
Zip Code*
Country*
Email*
Home phone number
(country code-city code-number)
Work phone number
(country code-city code-number)
Mobile phone number*
(country code-city code-number)
American Mobile Phone Number (while in US)
Gender

Emergency Contact Information

First Name*
Last Name*
Relationship*
Phone Number*
Mobile Phone Number*
Email

Spouse/Accompanying Person

Accompanying person/Spouse - meaning if your husband or wife is joining you, or someone else besides your professional team from your JCC ​

Title
First Name
Last Name

Spouses and accompanying persons will need to cover their own travel expanses, and make sure they have a valid USA visa.

Conference Package

Please choose relevant conference package:

Full Package {{price_cpFull}} USD
Or - choose from the following list:
  Opening night (Nov. 5) {{price_cpOpeningNight}} USD
  Monday Breakfast only (Nov. 6) {{price_cpMondayBreakfast}} USD
  Monday full day including meals (Nov. 6) {{price_cpMonday}} USD
  Tuesday Breakfast only (Nov. 7) {{price_cpTuesdayBreakfast}} USD
  Tuesday full day including breakfast and lunch (Nov. 7) {{price_cpTuesday}} USD
  Tuesday night program and dinner at UJA Federation of NY {{price_cpTuesdayNight}} USD
  Wednesday Breakfast only (Nov. 8) {{price_cpWednesdayBreakfast}} USD
  Wednesday full day including meals (Nov. 8) {{price_cpWednesday}} USD
  Thursday Breakfast only (Nov. 9) {{price_cpThursdayBreakfast}} USD
  Thursday full day including breakfast (Nov. 9) {{price_cpThursday}} USD
  Closing night (Nov. 8) {{price_cpClosingNight}} USD

Conference Package for Spouse/Accompanying Person

If your spouse/accompanying person is attending the conference, please choose relevant conference package:

My spouse/accompanying person is not attending the conference 0 USD
My spouse/accompanying person will be attending the conference full program {{price_cpFull2}} USD
Or - choose from the following list:
  Opening night (Nov. 5) {{price_cpOpeningNight2}} USD
  Monday Breakfast only (Nov. 6) {{price_cpMondayBreakfast2}} USD
  Monday full day including meals (Nov. 6) {{price_cpMonday2}} USD
  Tuesday Breakfast only (Nov. 7) {{price_cpTuesdayBreakfast2}} USD
  Tuesday full day including breakfast and lunch (Nov. 7) {{price_cpTuesday2}} USD
  Tuesday night program and dinner at UJA Federation of NY {{price_cpTuesdayNight2}} USD
  Wednesday Breakfast only (Nov. 8) {{price_cpWednesdayBreakfast2}} USD
  Wednesday full day including meals (Nov. 8) {{price_cpWednesday2}} USD
  Thursday Breakfast only (Nov. 9) {{price_cpThursdayBreakfast2}} USD
  Thursday full day including breakfast (Nov. 9) {{price_cpThursday2}} USD
  Closing night (Nov. 8) {{price_cpClosingNight2}} USD
Total - Conference Package
{{totalConferencePackage}} USD

Flight Information

I do not intend to fly to the conference

I'm purchasing my own flight ticket

Please purchase an economy flight ticket for me

The conference will take place from Sunday, November 5 - Thursday, November 9, 2017. A welcoming ceremony will be held on Sunday night, November 5, at 8:00 PM. The opening plenary at the hotel will begin on Monday, November 6, at 9:00 AM. We ask that all Fellows stay overnight at the hotel on Sunday night, November 5.

Guests are asked to purchase their own flight tickets.

After July 30th, flight prices will go up and JCC Global will not cover the difference in price.

As agreed upon, JCC Global will cover up to 50% of each Fellow’s economy flight ticket. Therefore, JCC Global will purchase one full ticket for the JCC professional, and the local JCC will purchase the second ticket.

In order for JCC Global to purchase your economy flight ticket, we need this information:

Please provide your flight information:

Passport number*
I have a valid passport and visa*
Arrival
Date of arrival*
Time of arrival
:
Arriving from – City*
Arriving from – Country*
Air Carrier
Flight Number
Arriving to - Airport (In NY)
Departure
Date of departure*
Time of departure
:
Leaving to – City*
Leaving to – Country*
Air Carrier
Flight Number
Leaving from - Airport (In NY)
Seat preference
Meal preference
Can you fly on the Sabbath?
Special requests
Frequent Flyer number
Frequent Flyer company

For your information, we will provide a bus from/to the airport, and from/to Manhattan Grand Central Terminal, on Nov. 5 and Nov. 9. We will update you once specific timings are set.

Passport Information

Please provide the following details and upload a scan of your passport with all relevant information:

First name as appears on passport
Last name as appears on passport
Passport number
Country of issue (Nationality)
Place of issue
Date of Birth
- -
Place of Birth
Passport issue date
- -
Passport expiration date
- -
Upload scan of passport

USA Visa

I'm a US or Canadian citizen / my country doesn't require a visa to the USA
I have USA Visa
Please provide the following details and upload a scan of your USA Visa with all relevant information:
 
USA Visa expiration date
- -
Upload scan of USA visa
I don't have USA Visa
Note:
Please make sure you apply for a USA Visa as soon as possible, since the Visa process might take a long time. For your Visa application process, we can provide you with a letter of invitation to the conference. Please contact: Natasha Malka, World Conference Coordinator at JCC Global office at Tel.: +972-2-625-1265 ex. 7 or natasha@jccglobal.org. We cannot proceed with your flight booking until we receive your Visa confirmation and scan.

Hotel Information

No Hotel Accommodation

The conference will take place at the DoubleTree by Hilton Hotel, Tarrytown, New York. Please note that space is limited and rooms will be booked on a first come first served basis at a rate of $181 US per night. JCC Global will cover the cost of up to 4 nights per person in a double occupancy room.

If you plan to arrive prior to the conference or to stay afterwards, please note that the hotel will honor the room rate 3 days pre/post conference based on the hotel’s availability. Hotel rates are shown below.

We will be assigning roommates for double occupancy rooms. By completing this registration form, you are agreeing to allow JCC Global to share your contact information and to assign your roommate. If you prefer not to have a roommate, you will be responsible for the additional associated costs.

Please choose your preference:

  Room type
  Double Room
I'm sharing a double room (twin beds)
I would like to share the room with:
Please find me a roommate
 However, in the event that one is not found, you will stay in a single room, for which there is an additional charge as per the rates below.
I'm sharing with my Spouse/Accompanying Person (double bed).
  Single Room
I would like to stay in a Single Room

 

Check-in date at the hotel
Check-out date from hotel

Current DoubleTree by Hilton Hotel rates:

Per person in a double room (included in Full Package)$90.5 including taxes
Hotel Room (Double or Single)$181 including taxes
Single Room supplement$90.5 including taxes
Spouse/Accompanying Person supplement$90.5 including taxes
Total for Hotel Accommodation - Between Nov. 5 - 9
{{hotelConferenceTotal | currency}} USD
{{hotelConferenceNights}} Conference Night(s)
Total for Hotel Accommodation - Before Nov. 5 / After Nov. 9
{{hotelExtraTotal | currency}} USD
{{hotelExtraNights}} Extra Night(s)
Total for Hotel Accommodation
{{totalHotelAccommodation | currency}} USD
{{hotelNights}} Total Night(s)

Please note:
Neither JCC Global, the DoubleTree by Hilton Hotel Tarrytown, nor our consultants, The Balcom Group, are responsible for guest room payments, personal property or any other matters between individuals sharing rooms and are held harmless in all matters relating to potential roommates.

Food Preference

The food at the conference will be Kosher style vegetarian. Tuesday night dinner at UJA Federation of New York will be Kosher.

Food preference

Kosher meals (I will require certified kosher meals and understand that my meals will be brought in from an outside caterer)

Please specify if there are additional restrictions and/or allergies

Other special dietary needs

Food Preference for Spouse/Accompanying Person

Food preference

Kosher meals (I will require certified kosher meals and understand that my meals will be brought in from an outside caterer)

Please specify if there are additional restrictions and/or allergies

Other special dietary needs

Special Needs

Mobility
Vision
Hearing
Other:
Required mobility aids:

Translation

Will you be needing translation from English?*

If yes, from what language?

Please mark the languages you understand:*
Hebrew
Russian
Spanish
Other:

Translation for Spouse/Accompanying Person

Will you be needing translation from English?

If yes, from what language?

Please mark the languages you understand:
Hebrew
Russian
Spanish
Other:

JCC Global – General Media Release Form

I hereby grant permission to JCC Global to take photographs and to make recordings of me, and to use them in all media for the promotion, public education, and/or fundraising activities of JCC Global.

I am 18 years of age or older.

I Agree*

Payment

No additional payment is required

Please select Payment Method *

Bank Transfer

  • Name of account: JCC Global
  • Account # 968-013-45160
  • NIS Account number: 0007045168
  • Mercantile Discount Bank
  • Branch # 646 at 1. Agron St., Jerusalem, Israel
  • Swift code: BARDILITXXX
  • Iban No. US$: IL 390 17 646 00 00 00 30 45163
  • Iban No. Euro: IL 040 17 646 00 00 01 20 45162

Check

  • Payable to JCC Global in US dollars, Euro or NIS.
  • Mailed to Israel: JCC Global, 12 Moshe Hess St. Jerusalem, 9418513, Israel.
    Please send via express mail since regular services in Israel are very slow as of late.

Credit Card via PayPal

  • In the next step (after clicking on "Continue" button), you will be taken to secure PayPal page in order to provide your credit card details.
  • Please note that additional fee of 3% will be charged to cover PayPal fees. (= {{jccTotalPayPal | currency}} USD)

My Organization

The costs will be paid by

Please note that this is subject to the organization's approval of your participation.

Total
{{jccTotal | currency}} USD

Final notes to the organizers

 

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