APPLICATION FOR KOACH KALLAH
February 14 - February 17, 2013
University of Pennsylvania, Philadelphia, PA
For more information about the Kallah, visit
PERSONAL INFORMATION AND PREFERENCES
Please list specific allergies:
I'm willing to help lead the following services:
My travel plans to/from Philadelphia are:
Thanks to a generous gift from Women's League for Conservative Judaism, registration is only $100 per person. Early bird registration for University of Pennsylvania students until January 25, 2013 is $54; $64 thereafter.
Type of Card
Credit Card Authorization
Choose from the following options (check all that apply):
Yes, I authorize a charge of $100 to my card.
Yes, I authorize a charge of $54 to my card (Penn Students Only; $64 after close of business on 1/25/13)
NOT authorize any charges to my card.