Project Makom

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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 Project Makom
Languages Spoken	English, Yiddish English, Yiddish, Hebrew English Yiddish Hebrew French Spanish Russian Other
Highest education level?
What is your current employment?
What is your secular education? Degrees, training, certification...
Jewish Education/ Schools that you attended
Where do you daven? Who is your Rabbi?
Please describe your religious outlook and lifestyle.
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?
When is a good time to reach you by phone?:
Do you have any ideas or suggestions for what Project Makom should do?
Please provide us with a few references.
Any other comments or questions for us?
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