The First Annual West Coast Yarchei Kallah on
Medicine and Halacha

Registration Form

Please complete this online form and send the registration fees to

The Jerusalem Center of Research
23 Yona Street
POB 57058
Jerusalem, Israel 95502 		       The Jerusalem Center for Research
Medicine and Halacha
c/o Rabbi A. Weiner
411 N. Formosa Avenue
Los Angeles, CA 90036

Name:
Address:
Home Phone:
Business Phone:
Mobile Phone:
Email Address:
Fax Number:
Medical Speciality:

Level of Learning

I can learn from original (non-English) text
yes no

I can learn with chevruta
yes no

I require a tutor
yes no

I need help finding lodging for the Yarchei Kallah: yes no
I am interested in CME credit: yes no

Registration Fee:
Before October 26, 2007: $400.00
At door: $500
Single morning or afternoon session: $75.00
Sponsorships: $1,000.00
 
Limited reduced fees available, please inquire

The registration fee should be sent to:

The Jerusalem Center of Research
23 Yona Street
POB 57058
Jerusalem, Israel 95502 		       The Jerusalem Center for Research
Medicine and Halacha
c/o Rabbi A. Weiner
411 N. Formosa Avenue
Los Angeles, CA 90036

Confirmation of participation will be made upon receipt of registration fees.

For further information, please contact us at: Telefax: 972-2-538-3558, Email: info@j-c-r.org
or locally, Dr. Dan Wohlgelernter at: 310-315-0101
or Lou Bersin, MPH: 323-243-6456


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Jerusalem Center for Research - Medicine and Halacha, P. O. Box 57058, Jerusalem, Israel
Phone and Fax: 972-2-538-3558, E-mail: info@j-c-r.org

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All rights reserved.