London 2012
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1. About you

If you would like to be kept informed of Jewish events, activities and interests that are planned to take place during the Olympic Games, or if you require any other specific information, please let us have your name and email address in the boxes below.

1. Name

Name

2. Email address

Email address

3. What is your gender?

What is your gender? Male

Female

4. What is your age range

What is your age range 18-30

31-45

46-65

65+

5. What is your home country

What is your home country

6. What is your main language?

What is your main language?

7. How well do you:

	Not at all	A little	Fluently
understand English?	*How well do you: understand English? Not at all	understand English? A little	understand English? Fluently
speak English?	speak English? Not at all	speak English? A little	speak English? Fluently

8. Do you have a physical disability? If so, please describe below.

Do you have a physical disability? If so, please describe below.

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London 2012Exit this survey

1. About you

London 2012
Exit this survey