Name* Title Mr.Mrs.RabbiRabbanitDr.Prof.Rabbanit Dr.Rabbi Dr.Rabbi Prof.MKMinister First Last Gender*MaleFemaleEmail* Personal websiteCellphone number*Do you use WhatsApp?*YesNoPositionIf you hold more than one, please input the most significant oneOrganizationField/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 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?*YesNoIf 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)WeekendSingle lectureHonorarium for Mizrachi eventsWould you be willing to offer a 10% discount for Mizrachi booked events?*YesNoDate 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 5779YesNoAre you available for the following dates (being considered for programs in other locations)May 11, 2019*6 Iyar 5779YesNoMay 18, 2019*13 Iyar 5779YesNoMay 25, 2019*20 Iyar 5779YesNoJune 1, 2019*27 Iyar 5779YesNoSection BreakPlease attach a photo here:*Hi-res if possibleBiography (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 1Email 1 Name 2Email 2 Name 3Email 3