Project Makom Volunteer Application

First Name *

Middle Name

Last Name *

Phone

Email *

Address 1 *

City *

State *

Zip *

Birth Date

// (mm/dd/yyyy)

Gender

Marital status?

How many children do you have?

How did you hear about us? (Optional additional details) *

Languages spoken?

English, Yiddish
English
Yiddish
Hebrew
French
Spanish
Russian
Other

Highest education level?

What is your current employment?

What is your secular education? Degrees, training, certification...

Please describe your Jewish education.

Where do you daven? Who is your Rabbi?

Please describe your religious outlook and lifestyle.

Makom: Please describe your personality

What are your interests/hobbies?

With what would you be willing to help a potential match? (required)

Host for Shabbos*
Help guide into my community
Discuss Jewish hashkafa/philosophy
Use my counseling/therapy skills
Help guide through higher education
Help guide into my industry/field of work
Help get a child into a Jewish school
Tutor in various subjects
Mediate between the person and their family
Help with legal issues (such as divorce or custody)
Help with shidduchim
Mentor in general/be a friend
Help Plan events
Help Fundraise

What is your experience with chareidi/chassidish communities?

Have you made the transition out of a chareidi community/helped someone make the transition?

What other additional skills do you have that you can contribute to individuals/ Project Makom?

Communication preferences?

Ideas, Suggestions, Questions, Comments, Concerns?

Please provide us with a few references.

Additional comments, questions or concerns?

Vaccination *

I confirm that my family and I have been vaccinated
Someone in my family is immoncomprised and I will provide documentation from my healthcare provider stating this.
I have a baby who is too young to be vaccinated

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Project Makom Volunteer Application