Logo

Values in Action Certificate Training Registration

This learning opportunity is being offered in partnership with the Jewish Teen Initiative at Combined Jewish Philanthropies (CJP). 
Waitlist
Hi!

Thank you for your interest in Values in Action. Unfortunately, the course you wanted to register for has reached capacity and is no longer open for registration. We would love to take your information down so we can be in touch with you if a spot opens up. Please click on this link to be redirected to a form to register for our waiting list.

Thank you!

Team VIA



For example, a nickname that you typically go by



Personal Information

We ask for the following information so that we can learn about the applicants for our programs. We look at this data in the aggregate and your answers have no bearing on your specific eligibility for the program. All the questions below are optional.

Please write in MM/DD/YYYY format

Address



About You



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.












Course Selection





If you have any questions or needs that arise, please contact us at viainfo@ieje.org. 




Logo

Thinking About Values in Action for Your Work

The following questions hone in on topics and skills that are the focus of the course.  


Extremely important for my work Very important Somewhat important Of little importance Not important at all
I am very experienced, and am able to teach others how to do this type of work I have a good deal of experience    I have some experience  I do not have any experience  

In thinking about your answers to the above questions about the topics and skills we will cover in the course, please elaborate on the following two questions: 


Very important Important Somewhat Important Not important at all



Logo
Dietary Requirements and Accessibility 
The following question asks about any allergies and dietary restrictions. We ask this in advance and do our best to accommodate you. Note that caterers often cannot adhere to last-minute requests. Please only write genuine restrictions. Note: all food provided is strictly Kosher.

Check all that apply


Check all that apply



Emergency Contact Information



Liability Waiver
(hereinafter, the “Participant”), at the M²: The Institute for Experiential Jewish Education Values in Action gathering, I, the undersigned participant, together with my heirs, executors, administrators, and assigns, hereby release, waive and forever discharge M²: The Institute for Experiential Jewish Education and/or their respective past and present employees, representatives, agents, officers, directors, affiliates, members, successors, assigns, and volunteers from and against any and all liability, claims, demands, actions, or causes of action of any and every kind and character which they had, have, or may have in the future, including but not limited to all injuries, damages, losses, or sicknesses, including contraction of Covid-19, which arise from or as a result of the Participant’s attendance in the program or participation in any associated activities. The undersigned herby further agrees to indemnify and to hold harmless the said Released Parties, of and from any and all liability, claims, demands, actions, rights of action, loss, damage, including attorney’s fees and costs, which arise from or as a result of the Participant’s attendance in the program or participation in any associated activities.

In further consideration for allowing the above-named Participant to attend and participate in the program, the undersigned does hereby give the Released Parties permission to capture and/or record the Participant’s name, image, likeness, persona, photograph, or voice, in any media and/or technology now known or later developed. Such use of his/her name, image, likeness, persona, photograph, or voice can be used throughout the world for educational, commercial, trade, or any other lawful purpose.


Logo

A Few Final Questions About You


We ask the following information because it is important that we understand the scope of Jewish educators we are reaching as well as to create a diverse and interesting cohort for this program.





Tuition Payment
The next page will take you to the PayPal site where you can pay the $150 tuition payment to attend. Please note that your participation in the course is not confirmed until after your payment has been processed.

Thank you. 

We don’t want cost to be a deterrent to participation; please reach out to viainfo@ieje.org if we can help.


M² Contact Information