Boston-Diller Teen Fellows Nomination 2023-2024

Diller Teen Fellows Nomination Form: 2023-2024

NOMINATIONS DUE: April 25, 2023

Please nominate a current 9th or 10th grader from Boston who:

Demonstrates leadership qualities and potential
Are thoughtful, curious, and excited to learn with and from their peers
Are dedicated to taking action in the community
Express an interest in exploring Jewish identities and practices
Would like to strengthen their connection with Israel and global Jewish communities

Diller Teen Fellows strives to bring together a diverse group of teenagers from different schools, backgrounds, and religious affiliations. Being part of Boston’s Diller Teen Fellows Program stimulates significant personal and communal growth.

If you have any questions, please contact Zach Goldberger, Program Director at 617-558-6512 or zgoldberger@jccgb.org

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Diller Teen Fellows is an immersive leadership program inviting a select group of Jewish teens from 7 countries and 32 communities to connect with one another, step up, lead their communities, and repair the world through experiential education. Throughout the yearlong Fellowship, teens develop leadership skills, connect in a global network of peers, strengthen their Jewish identities, and create ripples of good throughout the world.

More details about Boston’s Diller Teen Fellows program can be found at: https://www.bostonjcc.org/program/jcc-boston-diller-teen-fellowship/.

Your Information

Your Name*

First Name

Last Name

Organization & Title (if applicable)

Your Phone Number*

Your Email Address*

What is your relationship to the individual you are nominating?*

Nominee Information

Name of Nominee*

First Name

Last Name

Current Grade*

High School

Nominee's Email*

Nominee's Phone Number (if known)

Parent's name (please list one)

First Name

Last Name

Parent's Email (if known)

Please rank the nominee in regard to their ability to demonstrate exceptional... (scale of 1-5, 5 being the highest)*

Please rank the nominee in regard to their ability to demonstrate exceptional... (scale of 1-5, 5 being the highest)
	1	2	3	4	5	I don't know
Leadership qualities, communication skills, maturity and thoughtfulness	Please rank the nominee in regard to their ability to demonstrate exceptional... (scale of 1-5, 5 being the highest): Leadership qualities, communication skills, maturity and thoughtfulness (1)	Leadership qualities, communication skills, maturity and thoughtfulness (2)	Leadership qualities, communication skills, maturity and thoughtfulness (3)	Leadership qualities, communication skills, maturity and thoughtfulness (4)	Leadership qualities, communication skills, maturity and thoughtfulness (5)	Leadership qualities, communication skills, maturity and thoughtfulness (I don't know)
Cooperation in peer groups, thriving in a process oriented, small group setting	Cooperation in peer groups, thriving in a process oriented, small group setting (1)	Cooperation in peer groups, thriving in a process oriented, small group setting (2)	Cooperation in peer groups, thriving in a process oriented, small group setting (3)	Cooperation in peer groups, thriving in a process oriented, small group setting (4)	Cooperation in peer groups, thriving in a process oriented, small group setting (5)	Cooperation in peer groups, thriving in a process oriented, small group setting (I don't know)
Dedication to community service, social action, and/or volunteerism	Dedication to community service, social action, and/or volunteerism (1)	Dedication to community service, social action, and/or volunteerism (2)	Dedication to community service, social action, and/or volunteerism (3)	Dedication to community service, social action, and/or volunteerism (4)	Dedication to community service, social action, and/or volunteerism (5)	Dedication to community service, social action, and/or volunteerism (I don't know)
Interest in Jewish learning and a commitment to contributing to the Jewish community	Interest in Jewish learning and a commitment to contributing to the Jewish community (1)	Interest in Jewish learning and a commitment to contributing to the Jewish community (2)	Interest in Jewish learning and a commitment to contributing to the Jewish community (3)	Interest in Jewish learning and a commitment to contributing to the Jewish community (4)	Interest in Jewish learning and a commitment to contributing to the Jewish community (5)	Interest in Jewish learning and a commitment to contributing to the Jewish community (I don't know)
Desire to strengthen their ties with Israel and an awareness of issues concerning Israel	Desire to strengthen their ties with Israel and an awareness of issues concerning Israel (1)	Desire to strengthen their ties with Israel and an awareness of issues concerning Israel (2)	Desire to strengthen their ties with Israel and an awareness of issues concerning Israel (3)	Desire to strengthen their ties with Israel and an awareness of issues concerning Israel (4)	Desire to strengthen their ties with Israel and an awareness of issues concerning Israel (5)	Desire to strengthen their ties with Israel and an awareness of issues concerning Israel (I don't know)

Thank you for taking the time to nominate an outstanding teen!