Hazak Hazak Sponsorship Application
This application is for "Key Jewish Community members" who in the event of an emergency at a Jewish place of assembly are likely to be present and therefore need to be ready to respond so as to defend and preserve life and fulfill a litany of sudden Mitsvahs. We define Key Jewish Community members as "readily identifiable Jewish Men or Women who are staples of places of Jewish assembly such as Rabbis with congregations or students, employed staff of Jewish Institutions, and stalwarts of minyans,"
Sponsorship Applicant Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Have you submitted an application before?
Yes
No
List all of the names of any potential donors who may want to sponsor you
*
Community Participation Information
Shul or Jewish Place of Assembly Currently Attending
*
Check all that apply
I am FIRST AID/CPR certified.
I want to be FIRST AID/CPR certified.
I have taken a STOP THE BLEED class
I would like to take a STOP THE BLEED class
I carry defensive tools on my person.
I am willing to carry defensive tools on my person to defend life.
I would like to know more about self defense and situational awareness.
I have taken an Active Shooter response or House of Worship Defense class.
I would like to be better prepared for an Active Shooter or Attack on a House of Worship.
In the event of an emergency I would feel compelled to get involved and do my part.
Cover Letter
Please state why do you need the sponsorsip and what are your goals?
*
I hereby certify that all information are correct and to the best of my knowledge. I will also submit all the documents that will be asked from me for the application purposes.
Name & Signature
*
Date
-
Month
-
Day
Year
Date
Submit
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