2024 LGBTQ+ JOC Shabbaton Interest Form
Keshet Neshamot / Rainbow Souls Shabbaton
February 16-18, 2024
Pearlstone Retreat Center, Baltimore, Maryland
Proudly planned by The JOC Mishpacha Project and Keshet
The 2024 QJOC Shabbaton Registration form will be open soon!
To Hide
Mailing Address
Street
City / Town
State/Province/Region
Please use 2-Letter abbreviation for US states
x
Zip / Postal Code
Country
I confirm this is my current mailing address!
Contact Information
Title (Optional)
Please select...
Cantor
Dr.
Hazzan
Hon.
Kohenet
Lezbtzn
Madrich Ruchani
Madricha Ruchanit
Madrikh
Maggid
Maharat
Pastor
Prof.
Rabbi
Rav
Reb.
Rebbetzin
Rep.
Rev.
Sen.
First Name
Last Name
Email
Birthday
I confirm that I am over 18 years old
For Attendees
Would this be your first Keshet Shabbaton?
Yes
No
Would you need a travel scholarship in order to attend the Shabbaton?
Keshet takes financial accessibility seriously. Through the generosity of our donors and funders, we have a limited number of travel scholarships available.
Yes,
I would need a full travel scholarship.
Yes
, I would need a partial travel scholarship
No,
I would not need a travel scholarship. Please make that money available to others.
I'm not sure.
What amount would you need for a travel scholarship in order to attend the Shabbaton?
$
We recommend searching Google Flights for flights to airports near the Shabbaton to see how much flights currently cost. We will be in touch 6-8 weeks before the Shabbaton with more information about your travel scholarship.
Please tell us a fun fact about yourself!
What are you hoping to get out of the Shabbaton? What are you most excited for?
Anything else we should know?
Some More About You
Self-identification is important, and we understand that we each have our own understanding of the words used to describe our own experiences. So that we can best honor your identity and experiences, please describe how you identify in the free response box AND select (as many as you want) from the lists below.
In your own words, how do you identify regarding
race and/or ethnicity?
We recognize that identities are diverse and multifaceted. Your response to this question will be used solely for the purpose of creating an inclusive and respectful space for all participants.
Select the term(s) with which you most identify, even if the same as above (select all that apply).
African American
Asian
Black
Indigenous
Latinx/Hispanic
Middle Eastern
Mixed race/multi-racial
Native American/Alaskan Native
Pacific Islander/Native Hawaiian
White
Not Listed
Prefer not to answer
Listed in alphabetical order
In your own words, what is your
gender identity?
Select the term(s) with which you most identify, even if the same as above.
Agender
Cisgender (non-trans) Man
Cisgender (non-trans) Woman
Gender Non-conforming
Gender Variant
Genderqueer
Intersex
Non-binary
Queer
Transgender Man
Transgender Woman
Not Listed
Please share your
pronouns.
Select the pronouns you use, even if the same as above.
She/Her/Hers
He/Him/His
Ze/Hir/Hirs
They/Them/Theirs
No Pronoun
No Preference
Not Listed
In your own words, what is your
sexual orientation?
Select the term(s) with which you most identify, even if the same as above.
Asexual
Bisexual
Gay
Lesbian
Pansexual
Queer
Straight
Not Listed
Do you identify as Jewish?
Yes
No
Select the term(s) with which you most identify:
Ashkenazi
Bene Israel
Beta Israel
Mizrahi
Russian-speaking/from Former Soviet Union
Sephardi
Other (please describe below)
Prefer not to answer
Other:
How did you hear about this program? (Select all that apply.)
Email
Facebook
Twitter/X
Instagram
Family or Friend
The Keshet website
Other
Someone from Keshet reached out to me
I am interested in: (Select all that apply)
Attending the Shabbaton
Receiving updates about this Shabbaton so I can share with my community, organization, and/or QJOC friends
Do you identify as a QJOC (Queer Jew of Color)?
Yes
No