Form for NEW Readers

Please register me today so that I can be ON THE SAME PAGE with hundreds of others in my community for Long Island's first Jewish community read!

Welcome! For some of you this may be your first Jewish related activity. For others it may be one of the many. OTSP is designed for everyone. We invite you to register now.

Name First Last
Email Address
Confirm Email Address
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Daytime Phone - (###) - ### ####
Evening Phone - (###) - ### ####
How would you prefer to be contacted? Regular Mail Email
Gender Male Female
Age Under 21 21-30 31-40 41-50 51-60 61-70 71-80 Over 81
Where did you hear about On The Same Page? Synagogue/Community Center Library SAJES Bookstore Newspaper Friend On the net
This year's book is Coming Together, Coming Apart, by Daniel Gordis
Do you already have a copy of the book? Yes No
Which book-related events are you interested in attending? Group Discussions Workshops Panel Discussions Lectures Films
What might prevent you from attending a book related event? Location/Distance Need Child Care Weather Time of Event Going Alone
Providing the following information about the types of activites you participate in and the types of reading you do will help us select future book reads and organize events that meet the needs of our community readers
Please check the Jewish institutions/organizations/clubs with which you are associated. Select as many as apply Spiritual/cultural (e.g. Synagogue, Chabad, Hillel, Workman's Circle) Jewish Community Center (JCC) Cultural Arts (e.g. Dance group, Choir, Theater Group) Men's/Woman's Organization (e.g. Men's Club, Sisterhood, Hadassah, B'nai Brith) Activist/Political (e.g. American Jewish Committee) Israel-related (e.g. AIPAC, ZOA, WZO) Social Service (e.g. UJA/Federation, F.E.G.S., hospital, nursing home) Jewish Education (e.g. BJE, Hillel, Learn, SAJES) Jewish Camps
Please check the types of Jewish events or activites you participate in during the year. Select as many as apply Spiritual/Cultural/Religious Communial Holiday Events Home holiday celebrations Parades/Fairs/Fesitvals Adult education classes/workshops Political Events (e.g. marches, rallies) Cultural Arts Events Volunteer/Social Action related events
Reading Interests
How many books do you read a month? Less than 5 More than 5
Are you or have you been a member of a local or on-line book club? Which one(s):
Which local local/national newspapers do you read on a regular basis?
What other periodicals/special interest publications to you read?
Thank you for providing us with this information. If you have any questions, please contact: scalderone@sajes.org

Form for NEW Readers

Form for NEW Readers

This year's book is Coming Together, Coming Apart, by Daniel Gordis

Providing the following information about the types of activites you participate in and the types of reading you do will help us select future book reads and organize events that meet the needs of our community readers

Reading Interests

Thank you for providing us with this information. If you have any questions, please contact: scalderone@sajes.org