Women Champions for Change

* Please Choose:

Israeli Participant

International Participant

Personal Information

* Name Prefix

* First Name

* Last Name

* Name for Badge (in English)

* Nationality

* Mobile

* Email Address

Accommodation

We are happy to offer you complimentary accommodation at the Prima Hotel in Jerusalem, on a single room basis.

Check in: July 8, 2025

Check out: July 11, 2025

* Please Choose

Accommodation at the Prima Hotel

No accommodation

Travel Information

* Passport Number

Arrival Date and Time

Arrival Flight Number, Airline, and Airport

Departure Date and Time

Departure Flight Number, Airline, and Airport

If you have not reserved your flight yet, please keep us updated through the congress mail: [email protected]

Accommodation

We are happy to offer you complimentary accommodation at the Inbal Hotel in Jerusalem, on a single room basis.

Check in: July 7, 2025

Check out: July 11, 2025

If you wish to reserve a double room, a charge of $68 will be added to the registration cost.

* Please choose:

Accommodation at the Inbal Hotel- Single Room

Accommodation at the Inbal Hotel- Double Room ($68 additional charge)

No Accommodation

Do you have any accessibility needs related to your accommodation?

Food Preferences

Do you have any food preferences?

Vegetarian

Vegan

Food Allergies

* Food Allergies | Please Elaborate

Congress Participation

Congress Participation $100

* What organization are you affiliated with?

* Your Role / Title

* Will your spouse be joining us at the Maccabiah Opening ceremony on July 10, 2025?

YesNo

Participant Bio & Headshot

As part of our efforts to foster meaningful connections before and during the Congress, we kindly ask you to share a short bio and a recent headshot. These will be featured in Congress materials.

Short Bio (max 100 words): Please include your current role, key areas of work or interest, and any relevant achievements or affiliations.

Word count: 0

Headshot Upload (JPG or PNG): Please upload a high-quality, recent photo.

Media & Consent

I grant permission to the Congress organizers to photograph, record, and use my image and likeness in promotional materials, publications, websites, and social mediaI do not consent to be photographed or filmed

If you chose 'do not consent'-
We will make reasonable efforts to accommodate your preferences during group photography or recordings

Consent & Additional Information

If you have any accessibility requirements (mobility, hearing, visual, etc.) we should be aware of, kindly send us an email detailing your needs to: [email protected]

Is there anything else you'd like us to know to support your participation?

I approve sending verifications, instructions, and other messages related to the conference to the email address and phone number I have provided.

I have read and understand the Event Privacy Statement and agree to its terms.

I have read and understand the Event Terms and agree to them.

Payment

All payments must be completed to confirm registration. A receipt will be sent upon successful transaction.

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Subtotal	Subtotal	$
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Total	Total	$

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Total Amount

$0.00

* Payment Method

I agree to make out a check

After submitting the form you will be redirected to a secure website to perform the transaction. Only after doing so will your registration be completed.

Invoice/Receipt Information

* Email address for invoice/receipt

* Name for invoice/receipt

Company Name

Address

* Institute Name

* Institute Number

* Institute's accounting contact

* Institute's accounting phone

* Institute's billing address

I agree to make a bank transfer of the aforementioned amount

After submitting the form you will be redirected to PayPal to confirm the transaction. Only after doing so will your registration be completed.

Invitation code

In order to verify that you were invited, please fill in the code you recieved when invited

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