Mentors Application

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.

Please note: This is the advanced mentor program and not the student/young professional fellowship. For the Leadership student/young professional fellowship please click here

For more information please contact Shmuel Kott @ shmuelkott@gmail.com 848-2999169

Mentors Application

Questions marked with a * are required.

GENERAL INFORMATION

*1.	First Name:

*2.	Last Name:

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

*4.	Gender:

*5.	How did you hear about the Program?

*6.	Country of Birth:

SCHOOL INFORMATION

*7.	Year of Graduation:

*8.	University/College/Yeshiva/Seminary:

EMPLOYMENT INFORMATION (Mandatory if graduated)

*9.	Current Employer:

*10.	Job Title:

YOUR CONTACT INFORMATION

*11.	Address:

*12.	City:

*13.	State/Province:

*14.	Zip:

*15.	Country:

*16.	Phone Number:

*17.	Phone Number Cell/Work:

*18.	E-mail:

*19.	Your Marital Status:

EDUCATIONAL HISTORY

*20.	How many years of education (starting with first grade) completed?

*21.	What extracurricular activities, hobbies and organizations are you involved in? Please describe your participation in them:

JEWISH BACKGROUND

*22.	What Jewish Education have you had?

23.	If you attended afternoon Hebrew School, how many years did you attend?

24.	What was the Jewish Affiliation of your Hebrew School?

25.	If you attended Day School, how many years did you attend?

26.	What was the Jewish Affiliation of your Day School?

*27.	Your Current Jewish Affiliation:

*28.	How would you describe your Jewish education?

29.	If you specified "Other" Please explain

*30.	How would you describe your Hebrew speaking skills?

*31.	How would you describe your Hebrew reading skills?

*32.

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

Yes

No

33.	Position:

*34.

Have you been to Israel before?

Yes

No

35.	In What Context? (Bar/Bat Mitzvah, Year abroad, March of the Living, birthright israel, NCSY or Bnei Akiva, Yeshiva study, etc.)

*36.	What types of Jewish experiences have you had? (Bar Mitzvah, youth group, fraternity/sorority, etc

REFERENCES

Reference 1

*37.	Name

*38.	Relationship

*39.	Phone number

40.	Email

Reference 2

*41.	Name:

*42.	Relationship

*43.	Phone Number

44.	Email

SPECIAL REQUIREMENTS

*45.

Do you have any accessibility requirements or physical limitations or restrictions?

Yes

No

46.	If so, please elaborate.

*47.

Do you have any special dietary requirements?

Yes

No

48.	If so, please elaborate.

*49.

Are you currently receiving medical treatment or psychological counseling?

Yes

No

50.	If so, please elaborate

*51.

Are you currently taking any medication?

Yes

No

52.	If so, please elaborate

*53.

Have you ever been hospitalized?

Yes

No

54.	If so, please elaborate.

PERSONAL INFORMATION

*55.	What are your strengths and weaknesses?

*56.	In your opinion, what is the purpose/role of a madrich in a setting like Fellowships?

*57.	Please choose a date to come in for the interview:

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