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Apply Overview Qualifications Curriculum Timeline
Project Sulam Mentor Application

Part I: General Information

Name:

Personal Mailing Address:
Street:
City:   State or Province:   ZIP Code:
Personal Telephone:

School:
Address:
Street:
City:   State or Province:   ZIP Code:
School Telephone:
e-mail:
Part II: General Education

Colleges/Universities

School: Location: Major Area(s) of Study: Degree Earned: Date:
School: Location: Major Area(s) of Study: Degree Earned: Date:
School: Location: Major Area(s) of Study: Degree Earned: Date:
School: Location: Major Area(s) of Study: Degree Earned: Date:
School: Location: Major Area(s) of Study: Degree Earned: Date:
School: Location: Major Area(s) of Study: Degree Earned: Date:
School: Location: Major Area(s) of Study: Degree Earned: Date:
Non-Degree Programs, Distance Learning Programs, and Major Professional Development Conferences
Program: Location: Focus/Goals of Program: Date:
Program: Location: Focus/Goals of Program: Date:
Program: Location: Focus/Goals of Program: Date:
Program: Location: Focus/Goals of Program: Date:
Program: Location: Focus/Goals of Program: Date:
Part III: Judaic Education

Elementary and high school formal Judaic educational experiences

Program: Location: Denomination (if applicable): Years Attended:
Program: Location: Denomination (if applicable): Years Attended:
Program: Location: Denomination (if applicable): Years Attended:
Program: Location: Denomination (if applicable): Years Attended:
Program: Location: Denomination (if applicable): Years Attended:
Program: Location: Denomination (if applicable): Years Attended:
Elementary and high school informal Judaic educational experiences (youth group, summer camp, Israel trips, etc.)
School: Location: Denomination (if applicable): Years Attended:
School: Location: Denomination (if applicable): Years Attended:
School: Location: Denomination (if applicable): Years Attended:
School: Location: Denomination (if applicable): Years Attended:
School: Location: Denomination (if applicable): Years Attended:
School: Location: Denomination (if applicable): Years Attended:
University courses in Judaic studies (undergraduate and graduate)
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
School: Location: Course Title/Description:
Please rate your own Hebrew skill level
(scale of 0 to 5, with 0 being the lowest ranking and 5 being the highest ranking)

Speaking: Listening Comprehension: Reading Comprehension: Writing: Translation:
Please rate your own experience and comfort in the following areas of Judaic studies

Tefillah (Jewish Prayer): Novice Beginner Intermediate Expert
Chumash (Five Books of Moses): Novice Beginner Intermediate Expert
Mishna (Oral Law): Novice Beginner Intermediate Expert
Biblical Jewish History: Novice Beginner Intermediate Expert
Medieval Jewish History: Novice Beginner Intermediate Expert
Modern Jewish History: Novice Beginner Intermediate Expert
Israel and Zionism: Novice Beginner Intermediate Expert
Jewish Ritual Practice: Novice Beginner Intermediate Expert
Part IV: Employment History

Please include all positions in Jewish and general education as well as other relevant professional work (other positions in the Jewish community, administrative work, etc.)

School/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Name/Organization: Location: Title: Dates of Employment:
Part V: Essay

Please describe why you have applied to be a mentor for Project SuLaM and what you hope will come out of your participation, both for you and for the professionals with who you will work (250-500 words).

Part VI References

Please provide the contact information for the three individuals from whom you intend to request letters of reference. Please instruct your referees to send their letters in sealed envelopes, signed across the seal, directly to RAVSAK. There is no formal reference form. References should be sent on workplace letterhead. All letters must be received by December 1, 2008.

Reference A
Name:
Title:
Address:
Street:
City:   State or Province:   ZIP Code:
Telephone:
e-mail:

Reference B
Name:
Title:
Address:
Street:
City:   State or Province:   ZIP Code:
Telephone:
e-mail:

Reference C
Name:
Title:
Address:
Street:
City:   State or Province:   ZIP Code:
Telephone:
e-mail:

Part VII: Signatures

Please download this PDF file, fill it in, and send it to:

RAVSAK
120 West 97th Street
New York, NY 10025

Click Here for the last part of the form, then click "Submit Registration" below.