Summer 2025 Conference Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) PhoneWe are proud to be able to offer this seminar at no cost. It is subsidized by the OU Women's Initiative with the help of some generous donors.Consent - I have read and agree: Each woman will be provided with her own hotel room Monday evening (single occupancy). As per our policy, and in consideration of the safety and security of all attendees, summit rooms are reserved exclusively for registered participants and presenters. We are unable to accommodate additional guests in the rooms. We appreciate your understanding and cooperation.Each woman will be provided with her own hotel room Monday evening (single occupancy). As per our policy, and in consideration of the safety and security of all attendees, summit rooms are reserved exclusively for registered participants and presenters. We are unable to accommodate additional guests in the rooms. We appreciate your understanding and cooperation.Cohort(Required) 2022 2023 2024 Great Neck 2024 2025 Consent - Conference Attendance(Required) I look forward to attending the entire seminar program, beginning Monday July 14 at 8:30 AM, ending Tuesday July 15 at 5 PM, as part of my Fellowship commitment.Consent - Conference Attendance(Required) I look forward to attending the entire seminar program, beginning Monday July 14 at 8:30 AM, ending Tuesday July 15 at 5 PM.Will you be requesting travel reimbursement?(Required) I live more than 275 miles away from the hotel, and will be requesting up to $350 in travel reimbursement. I live between 75 and 275 miles away from the hotel and will be requesting up to $50 in travel reimbursement. I live less than 75 miles away from the hotel. If applicable, you will receive more details from Rachel Mazurek, our Operations Coordinator. Reimbursements will be processed after the seminar.Conference arrival time(Required)You may reserve a room for Sunday night ($180), which you can keep through Tuesday. A “break-fast” meal will be served Sunday evening after the fast (17 Tammuz). Those arriving Monday will check in that afternoon, with luggage storage available. I will arrive at the hotel Sunday, July 13, and would like to reserve a room I will arrive Monday morning by 8:30 AM and will sleep at the hotel on Monday evening (at no cost, as a guest of the Fellowship program) Please use the link below to reserve your room for Sunday evening. All payments must be made by June 30. In the invoice number section, please write fellowship seminar Sunday evening July 13 payment. Please enter the cost of $180. Please note, payment in full will confirm your reservation. This payment is non-refundable. https://ouwomen.org/ouwomen-payment-page/Please share any allergies or food needs (note the catering will be OU and cholov Yisrael)Please share any challenges, questions, or topics you’d like to discuss during our networking time—especially those that arise in your communal role or that you’d like to explore with other women in similar situations.(Required)Are there any specific women you would like to be grouped with during the small group discussions?Additional comments:Fellowship DirectoryWe plan to share a printed directory of Fellowship participants which will serve as a valuable resource for you. Please enter the information below as you would like it to be printed in the directory. Please check that all spelling and contact information is correct.Name(Required) First Last Cell phone(Required)Email(Required) Preferred method of contact(Required)Check all that apply Email Text Message WhatsApp Phone Communal role(Required)Check all that apply Rebbetzin Kallah Teacher Chinuch Professional Kiruv Professional Other Please describe your "other" role(Required)Number of years in role (s)(Required)Primary areas of communal and professional involvement(Required)Your positionOrganization/company Add RemovePlease share up to 5 areas of communal and professional involvement - in the exact way you would like it to appear in the directory. (Click the circle on the right to add additional positions.)Thumbanil Photo(Required)Please upload a picture so women can put a face to the name and stay connected. This is for directory use only and will not be posted online. Max. file size: 512 MB.Reservation credit card holdPlease enter your credit card information to secure your reservation. It will NOT be charged. The seminar costs are fully covered by the OU Women's Initiative. In the event that you do not join us, your card will be charged as per below, a small part of the cost that we have committed based on this reservation.I agree to the cancellation policy - please check each circle to agree:$175 if cancelled before July 1(Required) $175 if cancelled before July 1 $350 if cancelled on or after July 1(Required) $350 if cancelled on or after July 1 This field is hidden when viewing the formNewsletter Signup Yes, I would like to subscribe Total Media Release(Required) By checking this box, I acknowledge and represent that I am at least eighteen (18) years of age and that I have read the THE ORTHODOX UNION MEDIA RELEASE, and that I understand it and sign it voluntarily. ORTHODOX UNION MEDIA RELEASE From time to time, The Union of Orthodox Jewish Congregations of America, and its programs, employees and agents (together, the “Orthodox Union”) take photographs and videos of individuals, including minors, who attend or participate in Orthodox Union events, programs, and other offerings. The Orthodox Union engages in these activities for purposes relating to the advancement of the religious, spiritual, charitable, and educational goals and objectives of the Orthodox Union, including but not limited to the sharing of photos/videos in newsletters, on our blogs, and on our website and social media pages for the purpose of keeping our members and others informed of the Orthodox Union’s events and other activities. Please complete this form to give us permission to take photos/videos of you and/or your children when you participate in Orthodox Union events or programs and to use those photos/videos in our printed and online publicity: I hereby authorize the Orthodox Union to take photographs and/or video of me (or my children) when I (or my children) participate at Orthodox Union events or programs. I grant the Orthodox Union full rights to use and share the images resulting from the photographs and/or videos and any reproductions thereof (the “Recording”), in whole or in part, along with my (or my children’s) name, biographical information and quotations for any purpose including fundraising, publicity, advertising, or on social media, all without further obligation or compensation. I hereby waive any right of review or approval regarding the Recording and the Orthodox Union shall have the right to edit or delete the Recording in its sole discretion. I understand that all rights in and to the Recording shall be the Orthodox Union’s sole and absolute property. I understand that if I access the Orthodox Union’s services through a third party platform, product, service, or application (a “Third Party Service”), content and related information generated while accessing OU’s services in this manner may be monitored, captured, and or recorded by the third parties that provide such Third Party Services. I consent to the use and sharing of personal information by any such third party as described in the privacy policy available through the Third Party Service. I release and forever discharge the Orthodox Union from all causes of action, suits, or liability of any kind arising from or in connection with the use or publication of any Recording of me or my children made in connection with my participation in Orthodox Union events. I waive any right of privacy associated with the Recording and I waive any right to compensation related to the use of the Recording. I HAVE READ THIS AGREEMENT AND AM FULLY AWARE OF ITS CONTENTS, INCLUDING THE RELEASE THAT I HAVE AGREED TO HEREIN. I warrant that I am at least eighteen years of age (or, if not, that my parent or legal guardian has agreed to the foregoing and signed below) and that I have the full and unrestricted authority to enter into a contract for myself (or, if not, that my parent or legal guardian has agreed to the foregoing and signed below). If any provision of this agreement is held to be unenforceable, the remainder of it shall continue to be in full force and effect. This waiver shall remain in effect until such time as I advise the OU otherwise in writing.