First name
*
Last name
*
Email
*
Address line 1
*
Address line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
Other
Zip code
*
Country
*
Canada
Israel
USA
Date of birth
*
-
Month
-
Day
Year
Date
Cell phone number:
*
With which Ramah camp are you primarily affiliated?
Berkshires
California
Canada
Chicagoland Day Camp
Darom
New England
Northern California (Galim)
Nyack
Philadelphia Day Camp
Poconos
Rockies
RSA
Seminar
TRY (Tichon Ramah Yerushalayim)
Washington, DC Day Camp
Wisconsin
Select the industry in which you primarily work:
*
Agriculture or forestry
Academia or research
Accounting
Arts or entertainment
Broadcasting
Cantor
Charity or volunteer work
Computer services or IT
Construction
Consulting
Creative arts or design
Education/teaching (K-12)
Engineering
Environmental planning/services
Finance/Banking
Food services
Gasoline stations
Government or public administration
Healthcare
Higher education
Hospitality or events
Hotel or food services
Information services or data processing
Jewish communal professional/Jewish educator
Law or legal services
Law enforcement or security
Leisure, sport, or tourism
Maintenance or repairs
Manufacturing
Marketing, advertising, or PR
Media or digital information services
Medicine
Military
Motor vehicles and parts dealers
Museums
Music
Nursing or residential care facilities
Postal services
Public services or administration
Publishing
Rabbi
Real estate
Recruiting or HR
Retail
Sales
Science or pharmaceuticals
Social work
Transportation, logistics, or warehousing
Telecommunications
Utilities
Waste management
Wholesale trade
N/A
Other
If you selected "other," please describe the industry in which you work. If you are not currently working or are retired, please let us know:
Name of your company or organization:
*
Your job title:
*
In which of the following are you potentially interested? Check all that apply.
*
Providing a virtual internship
Providing an in-person internship
Providing virtual mentorship
Providing in-person mentorship
Taking part in a focus group to provide input on this initiative
Volunteering on a committee to help identify potential job placements
Providing mentorship or an internship to a person with disabilities or mental health challenges
Connecting with others in my field
Other
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