Jewish National Fund - Survey - Tu BiShvat Across America Kit Order Form

Thank you for your interest in Tu BiShvat Across America! Please fill out the information below in order to receive your kit, which will arrive in a useful, reusable canvas bag, and include a folder of materials, tree planting forms, posters, evaluation cards, and JNF Blue Boxes™. Visit www.jnf.org/treesource for sermons and program ideas.

*1.

Question - Required - Congregation/Organization Name

*2.

Question - Required - Congregation/Organization Street Address

*3.

Question - Required - Congregation/Organization City

*4.

Question - Required - Congregation/Organization State

*5.

Question - Required - Congregation/Organization Zip Code

*6.

Question - Required - Congregation/Organization Phone Number

7.

Question - Not Required - Congregation/Organization Fax Number

8.

Question - Not Required - Congregation/Organization Website Address

*9.

Question - Required - Contact Person's Name

*10.

Question - Required - Contact Person's Title

*11.

Question - Required - Contact Person's Email Address

12.

Question - Not Required - Contact Person's Phone Number (if different than above)

*13.

Question - Required - Congregation/Organization Affiliation (select one response)

*14.

Question - Required - Date of Tu BiShvat Program

*15.

Question - Required - Type of Tu BiShvat Program (select as many as you'd like)
Please make between 1 and 4 selections from the choices below.

	Shabbat Service
	Special Program
	Seder
	Other (please specify)

16.

Question - Not Required - If you chose "Other" please specify here

17.

Question - Not Required - Are you interested in having a free speaker for your Tu BiShvat program?

*18.

Question - Required - How many Tree planting forms would you like? Please note, for every 5 trees planted, the person will receive a free reusable canvas tote bag. (Select one response)

*19.

Question - Required - How many free JNF Blue Boxes would you like? (Select one response)

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Tu BiShvat Across America Kit Order Form