Rekindle Application 2024: Cohort #3

Full Name*

First NameLast Name
What do you prefer to be called (for your nametag or nameplate)?*
What pronouns do you prefer?*

He/himShe/herThey/themI prefer not to answerOther
Do you want your pronouns on your nametag?*

YesNo
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
How did you find out about Rekindle?*
Your title (if employed):*
Name of the organization you work for (if none, put n/a):*
Besides your employer, are you involved with service or community organizations? Please list volunteer organizations, committees, or boards, and your roles (if applicable).*
Where do you worship, if anywhere? Please enter your church, synagogue, or other house of worship name, if applicable. Feel free to let us know more about your denomination or affiliation.*
Rekindle Fellowship sessions include time for dinner, and we provide the meal. Do you have any dietary restrictions we should know about? We will accommodate as best we can. (Allergies, vegan, vegetarian, hallal, kosher, etc.) Please write "None" if this does not apply.*
Do you require an ASL interpreter or other assistive technologies to support you? Please explain. *
Will participating in the Rekindle Fellowship prohibit you from earning potential wages or overtime at work or require you to pay for childcare? Please explain.
Does childcare pose an attendance issue for you? Explain. [Please add the age(s) of your child(ren).]*
Does access to transportation pose an attendance issue for you? Explain if applicable.*
In five sentences or less, tell us why you want to be a Rekindle Fellow.*
We are interested in participants who are open minded and still learning how to be allies to others. Tell us about where in your journey to allyship you are at this time.*
When it comes to making Rochester a more equitable, more inclusive, more just city, what are some areas/issues that interest or motivate you?*
Please insert your bio below, which we will share with the other Fellows and which might be shared publicly with your permission. In addition to the typical stuff – education, work, family, etc. – include things like what you do for fun, and what motivates you. What do you want other Fellows to know about you?*
What do you hope to accomplish or learn as a Rekindle Fellow?*
Thank you for applying to the Rekindle Rochester Fellowship. We will notify you by email once you have been accepted for the program. Please reach out to Monica with any questions: MGebell@JewishRochester.org.

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Rekindle Rochester Fellowship

Cohort 3 Application