Name* Title Mr.Mrs.RabbiRabbanitDr.Prof.Rabbanit Dr.Rabbi Dr.Rabbi Prof.MKMinister First Last Gender* Male Female Email* Personal website Cellphone number* Do you use WhatsApp?*YesNoPositionIf you hold more than one, please input the most significant one Organization Field/Profession*(tick all that apply) Educator Community/Synagogue Rabbi Business & Management Government & Politics Leadership & Motivation Tour Guide Where are you an educator?*(tick all that apply) Yeshiva Midrasha Academic Yoetzet Halacha Other Speaking Topics*(tick all that apply) Torah Israel Politics Community Eretz Yisrael Inspirational Mussar/Character Development Jewish Education Family Education Halacha & the Modern World Campus/Students Other Other speaking topicsLanguages you feel comfortable teaching in* English Hebrew French German Russian Portuguese Spanish Arabic Sample Topics - GeneralPlease list some sample topics or upload a file belowSample Topics - Related to IsraelPlease list some sample topics or upload a file belowSample topics upload Drop files here or Select files Max. file size: 256 MB. Links to sample audio or videos of you speaking and/or online classese.g. include link to existing shiurim on site such as YUTorahOnline live video shiurimAre you available for video conferencing shiurim?* Yes No If so, for which audiences? Schools Shuls Other organizations (JCC, youth movement, etc) Families Individuals Other Which other audiences? How much would your honorarium be per video shiur? (in $US) Comments about video conferencing shiurim:Regular Honorarium Amount in addition to payment of the plane ticket (This will not be made public)Weekend Single lecture Honorarium for Mizrachi eventsWould you be willing to offer a 10% discount for Mizrachi booked events?* Yes No Date availabilityPlease note: stating availability for a number of dates is not a commitment to travel for all of themAre you available for the weekend of May 4, 2019 (the date chosen for the program in the US)?*29 Nissan 5779 Yes No Are you available for the following dates (being considered for programs in other locations)May 11, 2019*6 Iyar 5779 Yes No May 18, 2019*13 Iyar 5779 Yes No May 25, 2019*20 Iyar 5779 Yes No June 1, 2019*27 Iyar 5779 Yes No HiddenSection BreakPlease attach a photo here:*Hi-res if possibleMax. file size: 256 MB.Biography (200 word limit)*Do you have any recommendations for speakers to join the Mizrachi Speakers Bureau? Yes RecommendationsPlease fill in the name and email of up to 3 recommendationsName 1 Email 1 Name 2 Email 2 Name 3 Email 3
