Nomination for M² Senior Educators Cohort 7
Welcome
If you know someone who would benefit from participating in the M² Senior Educators Cohort please share their contact details in this form. Thank you!
Your Contact Information
First Name
Last Name
Email Address
Title
Employer
It is common for a workplace to be referred to by multiple names, so please try a few options to find your organization from the options above. For example, Marlene Meyerson JCC Manhattan may also be referred to as JCC Manhattan. If you cannot find your organization, please select ‘other’ in the next field and enter it manually.
My employer is not listed
Please Select...
Please select...
Self Employed
Other
Please write the full name or the most recognized version of your employer or organization.
AccountId
Your Nominee's Information
First Name
Last Name
Email Address
Title
Employer
It is common for a workplace to be referred to by multiple names, so please try a few options to find your organization from the options above. For example, Marlene Meyerson JCC Manhattan may also be referred to as JCC Manhattan. If you cannot find your organization, please select ‘other’ in the next field and enter it manually.
AccountId
My nominee's employer is not listed
Please Select...
Please select...
Self Employed
Other
Please write the full name of your nominee's employer or organization:
If applicable, please provide the full name of your nominee's employer (for example: 'B'nai Brith Youth Organization' instead of 'BBYO' or 'Marlene Meyerson JCC Manhattan' instead of 'Manhattan JCC.')"
What is your relationship to the nominee?
Friend
Family
Colleague
Supervisor
Other
Please Specify
Why do you feel this person would benefit from participating in the M² Senior Educators Cohort?
ProgramID
Please select...
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a0v5f00000BdsyOAAR
Program Name
I would like to nominate another person
Please select...
Yes
No