If you are interested in joining us for the mission to visit Bardejov, please take a moment to complete and submit the following survey or click here to open a printer friendly Adobe Pdf to print and then fax us at (626)773-8825. Thank you!

Application to Join the Mission to Visit Bardejov in June 2012

1. My contact information:
Name:

Address:


Telephone:
Work: Home: Cell:
Fax:
Email:

2. How many will be travelling in your party?:

3. Other information about me:

To submit this survey, please click here.



Bardejov Jewish Preservation Committee, 905 S. Fair Oaks Avenue, Pasadena, CA 91105, USA
Tel: (626)773-8801, Fax: (626) 773-8825, Email: info@bardejov.org