Pardes Elul Program

Gender

Preferred Pronoun

Marital Status:

(only if applicable) Partner's Last name:

Partner's First name:

Age of Children (if applicable):

I am a Pardes alum:

YesNo

Pardes program & year:

Mobile Number

Home Phone Number:

Please include full dialing codes

Permanent Address

Permanent Address Line 1:

Permanent Address Line 2:

City:

State

ZIP Code:

Country

Current address if different from address above

Current Address Line 1:

Current Address Line 2:

City:

State

ZIP Code:

Country

Name of Undergraduate Institution:

Enter school name if not found on drop down list:

Location:

Major/Field of Study:

Enter major field of study if not listed:

Undergraduate Degree:

Enter undergraduate degree if not listed::

Start Date MM/YYYY:

End Date MM/YYYY:

Comments:

Name of Graduate Institution:

Enter school name if not found on drop down list:

Location:

Graduate Degree:

Enter graduate degree if not listed:

Major/Field of Study:

Enter major field of study if not listed:

Start Date: MM/YYYY

End Date MM/YYYY:

Current Full Time Employment (if applicable)

Employer:

Position:

Location: City

State

Country

Start Date MM/YYYY

End Date MM/YYYY:

Organizational Involvement #1 (Non-Jewish)

Organization Name:

Position:

Location: City

State

Country

Start Date (MM/YYYY):

End Date (MM/YYYY):

Comments:

Organizational Involvement #2 (Non-Jewish)

Organization Name:

Position:

Location: City

State

Country

Start Date (MM/YYYY):

End Date (MM/YYYY):

Comments:

Check if you were ever awarded any of these scholarships:

Fulbright ScholarshipMarshall ScholarshipRhodes ScholarshipBarry M. Goldwater Scholarship

Fulbright Scholarship start date MM/YYYY

Fulbright Scholarship end date MM/YYYY

Fulbright Scholarship Comments

Marshall Scholarship start date MM/YYYY

Marshall Scholarship end date MM/YYYY

Marshall Scholarship Comments

Rhodes Scholarship start date MM/YYYY

Rhodes Scholarship end date MM/YYYY

Rhodes Scholarship Comments

Goldwater Scholarship start date MM/YYYY

Goldwater Scholarship end date MM/YYYY

a. Jewish Education

Name of Jewish Learning Institution #1:

Location: City

State

Country

Area of Study:

Level:

Start Date:(MM/YYYY)

End Date:(MM/YYYY)

Comments:

Name of Jewish Learning Institution #2:

Location: City

State

Country

Area of Study:

Level:

Start Date:(MM/YYYY)

End Date:(MM/YYYY)

b. Jewish Summer Camp

Name of Camp:

Enter name of Camp if not found on drop down list:

Location: City

State

Country

Position(s) (i.e. camper, counselor, etc.):

Start Date: (YYYY)

End date:(YYYY)

c. Hillel Foundation for Jewish Campus Life

Are/were you involved with Hillel while at undergraduate school?

YesNo

Position(s):

Start date: (MM/YYYY)

End Date:(MM/YYYY)

Comments:

Are/were you involved with Hillel while at graduate school?

YesNo

Position(s):

Start date: (MM/YYYY)

End Date:(MM/YYYY)

Comments:

Adamah Start date MM/YYYY

Adama End date MM/YYYY

Adamah - Position

AJWS Start date MM/YYYY

AJWS End date MM/YYYY

AJWS - Position

Avodah Start date MM/YYYY

Avodah End date MM/YYYY

Avodah - Position

Berrie Fellowship Start Date MM/YYYY

Berrie Fellowship End date MM/YYYY

BIMAs Start date MM/YYYY

BIMA End date MM/YYYY

BIMA at Brandeis - Position

BCI Start date MM/YYYY

BCI End date MM/YYYY

BCI - Position

Dvar Tzedek Start Date MM/YYYY

Dvar Tzedek End date MM/YYYY

Genesis Start date MM/YYYY

Genesis End date MM/YYYY

Genesis - Position

JDC Start date MM/YYYY

JDC End date MM/YYYY

JDC - Position

JOI Start date MM/YYYY

JOI End date MM/YYYY

JOI - Position

Joshua Venture Start Date MM/YYYY

Joshua Venture End Date MM/YYYY

Maimonides Start date MM/YYYY

Maimonides End date MM/YYYY

Maimonides - Position

PresenTense Start date MM/YYYY

PresenTense End date MM/YYYY

Schusterman Start Date MM/YYYY

Schusterman End date MM/YYYY

Teva Start date MM/YYYY

Teva End date MM/YYYY

Teva - Position

Wexner Graduate Start date MM/YYYY

Wexner Graduate End Date MM/YYYY

Wexner Heritage Start Date MM/YYYY

Wexner Heritage End Date MM/YYYY

e. Additional Jewish Organizational Involvement

Jewish Organization #1 Name:

Position(s):

City

State

Country

Start date: (MM/YYYY)

End Date:(MM/YYYY)

Comments:

Jewish Organization #2 Name:

Position:

City

State

Country

Start Date: (MM/YYYY)

End Date: (MM/YYYY)

Comments:

a. Study Abroad Program at an Israeli University

University

Other University if not found on drop down list

Area of study

Start date (MM/YYYY)

End date (MM/YYYY)

b. Selected organized programs to Israel If you participated in any of these organized programs to Israel (see drop-down lists), please indicate dates of participation and position.

Program #1:

Position (i.e.participant, staff)

Start date (MM/YYYY):

End date (MM/YYYY):

Program #2:

Position (i.e. participant, staff)

Start date (MM/YYYY):

End date (MM/YYYY):

c. Other organized programs to Israel

Name of Program:

Position (i.e. participant, staff)

Start date (MM/YYYY):

End date (MM/YYYY):

Synagogue/Minyan

Name:

Rabbi's Name:

Affiliation

Other affiliation:

City

State

Country

Comments:

Describe briefly your experience with formal Jewish text study:

How would you assess your ability to comprehend a passage in Hebrew from the Talmud or Humash?

Describe briefly your level and training in Modern Hebrew:

Can you have a substantive conversation in Hebrew?

Yes With difficulty No

Can you navigate buses, restaurants and purchases in Hebrew?

Yes With difficulty No

Can you read a newspaper article in Hebrew?

Yes With the help of a dictionary With partial understanding No

Can you read a narrative from the Torah?

Yes With the help of a dictionary With partial understanding No

Title

First Name

Last Name

Organization

Position

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