First Name

Last Name

Primary email address

Secondary email address

Which email address would you prefer to receive programmatic-related communications?

Primary email addressSecondary email address

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.

Date of Birth

Please write in MM/DD/YYYY format

We strive to create a safe and inclusive space for all gender identities at M². If you feel comfortable doing so, please share your pronouns here. If you want to learn more about personal pronouns, you can do so here.

Mailing Address

We will be sending you physical materials in the mail prior to the course, please provide the best address for us to send you these materials.

Country

State

Province

Account ID

My employer is not listed

Please Select

Please write the full name or the most recognized version of your employer or organization:

I have been working in the Jewish community for…

Other sector of Jewish education

Other educational setting

Which of the following best describe your work? Choose all that apply

I work directly with participants in the programs run by my organizationI support and/or supervise those who work directly with participantsI work in an administrative or managerial role without a direct connection to programmingOther, please elaborate:

Other, please elaborate:

How did you hear about this course? Please check all that apply

Other, please speify

Accessibility Needs

Please confirm your course dates:

May 7, 15, 21, & 28 from 1-3 ET

Please select a date for Class 2:

Monday 5/8, 1-3:30pm ETThursday 5/11, 1-3:30pm ET

Please select a date for Class 3:

Monday 5/15, 1-3:30pm ETThursday 5/18, 1-3:30pm ET

Please select a date for Class 4:

Monday 5/22, 1-3:30pm ETThursday 5/25, 1-3:30pm ET

Thinking About Values in Action for Your Work

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

How important are the following areas for your work?

	Extremely important for my work	Very important	Somewhat important	Of little importance	Not important at all
Facilitating discussions about challenging social issues
Leading discussions or programs where participants have a chance to reflect, share and seek to understand themselves better
Enabling participants to explore what matters to them most about challenging issues
Using Jewish ideas and wisdom as part of facilitating conversations
Designing educational programs which involve the intentional use of Jewish values
Activating participants to respond to challenging issues through taking positive action

What is your level of experience with each of the following?

	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
Facilitating discussions about challenging social issues
Leading discussions or programs where participants have a chance to reflect, share and seek to understand themselves better
Enabling participants to explore what matters to them most about challenging issues
Using Jewish ideas and wisdom as part of facilitating conversations
Designing educational programs which involve the intentional use of Jewish values
Activating participants to respond to challenging issues through taking positive action

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:

1. In what area of your work do you see Values in Action as most relevant? Please provide an example, and explain why Values in Action is relevant.

2. What would be the most beneficial take-away from the course for you?

We aspire to create an online learning experience that is lively and engaging. What makes online learning a great experience for you?

How important were each of the following reasons for your decision to take the Values in Action Course?

	Very important	Important	Somewhat Important	Not important at all
Interest in the topic
Need for professional development credits
Recommendation from my supervisor
Improve my educational knowledge and skills
Resume building

Other, please elaborate:

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.

What is your gender? (ex: woman, man, non-binary, etc.)

Please elaborate

We want to get to know you and seeing your picture will help us! Please upload a copy of your headshot. Thank you.

Tuition Payment

The next page will take you to the PayPal site where you can pay the $75 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.

If you will be using a different email address than your own to make your payment on the next page, please indicate the new email address here:

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Values in Action Certificate Training Registration

Personal Information

Mailing Address

About You

Accessibility Needs

Class Selection

By clicking here, I am committed to attending all 4 sessions live. If you would like to discuss this further, please email viainfo@ieje.org

Please note that upon submitting this form you will automatically be registered for the classes you selected above.

Thinking About Values in Action for Your Work

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

A Few Final Questions About You