| World Union for Progressive Judaism

Request Placement
- Name*
  First Last
- Phone*
- Email*
- Congregation Affiliation
- Current Location*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Where did you complete your rabbinic studies?*
- Year of graduation*
- Placement Details
- Dates Available/Holiday Requesting
- Is there a particular congregation or city/state/country to which you would like to be sent?
- Is there a particular congregation or city/state/country to which you DO NOT want to be sent?
- Financial needs (check all that apply):
  Transportation
  Flight
  Accomodation
  Other
- Interests/Special Skills
- Previous Placement Experience(s)
- Please use this space to tell us anything else we should know in order to make the best possible match between you and a congregation: