Hitorerut Incubation Award Application

Full Name*

First NameLast Name

Phone Number*

Area CodePhone Number

E-mail*

Confirmation Email

Location you'd like to work from*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

What social justice issue animates you that you could commit a year to? Why?*

What initiative do you propose that will further this social justice goal?*

How would you engage the national Modern Orthodox community around this issue and your initiative?*

What is your plan for implementing your initiative? How and where would you implement your initiative? Please include how you would 1. educate the Orthodox community or others; 2. develop others as future leaders on your issue; and / or 3. create real change for vulnerable populations.*

What would be your primary measures of success?*

What obstacles do you foresee, and how do you anticipate overcoming them?*

Please share your qualifications for this Award, including Orthodox affiliation; past social justice experience; prior accomplishments or leadership positions; experience implementing other programs, campaigns, or projects; or other qualifications you believe would be relevant.*

Please attach your resume*

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