Register for RAJE Madrichim Program

RAJE - The Russian American Jewish Experience.
RAJE is an evolving organization committed to sparking Jewish life in Russian American society. As the Russian Division of Gateways, we are passionate about building a community that embraces Russian speaking Jews from all walks of life.
The core of RAJE is our Fellowship Programming.

Register for RAJE Madrichim Program

SPRING 2011 Semester

Questions marked with a * are required.

General Information

*1.	First Name

*2.	Last Name

*3.	Date of Birth (mm/dd/yyyy)

*4.	Gender

*5.	Country of birth

6.	If you were not born in the US, year of arrival in to the US:

*7.	City of birth

*8.	Address

*9.	City

*10.	State

*11.	Zip

*12.	Home Phone

13.	Work phone

*14.	Cell phone

*15.	E-mail

Family Background

*16.	Marital status

17.	If married, name of your spouse

*18.	Mother's First Name

*19.	Mother's Last Name

*20.	Mother's Occupation

*21.	Mother’s phone

*22.	Father's First Name

*23.	Father's Last Name

*24.	Father's Occupation

*25.	Father’s phone

*26.	Parents' Marital Status

Parent’s address

*27.	Street address

*28.	City

*29.	State

*30.	Zip

*31.	Was your father born Jewish?

*32.	Was your Mother born Jewish?

Educational Information

*33.	High School attended

*34.	Year of graduation

*35.	Undergraduate University/College attended

*36.	Year of graduation/Projected graduation

*37.	Undergraduate major

38.	Graduate school attended

39.	Year of graduation/Projected graduation

*40.	List any groups, clubs, or fraternities/sororities you belong to. (Please indicate if you hold a position in any of these organizations and, what your position is):

*41.	Describe your academic interests, hobbies, and extra-curricular activities

Employment background

*42.	Current employment status

*43.	Name of employer

*44.	Position

*45.	City or Borough where you work

Jewish Background

*46.

Have you participated in Jewish educational programs before?

Yes

No

47.	If yes, please list which program(s) (include location, month, & year)

*48.

Have you participated in a Birthright trip to Israel

Yes

No

49.	If yes with which Birthright provider

*50.

Do you know how to read Hebrew?

Yes

No

*51.

Have you ever attended a Jewish School?

Yes

No

52.	If yes, what was the name of the school?

53.	How many years did you attend?

54.	Which grades?

*55.	What is your current Jewish affiliation?

*56.

Do you hold any leadership/professional positions in Jewish organizations?

Yes

No

57.	If yes, please describe

*58.

Have you ever participated in any Jewish educational trips (not including RAJE trips or Birthright)

Yes

No

59.	If yes, please describe (include name of organization, year of trip, and destination)

Involvement in RAJE

*60.

Have you participated in RAJE Fellowship programs or trips?

Yes

No

61.	If yes, please list programs in which you participated, include program name, year and semester

62.	Please list any friends who have participated in RAJE programs

63.	Please list any friends who are applying with you to the program

*64.	Briefly explain what you hope to gain from the RAJE Fellowship program

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