LA Diller Teen Fellows Application 2015-2016 Header Image

Diller Teen Fellows Application (2015-2016)

Deadline: Sunday, May 18, 2015

Application Requirements:

A complete application includes:
- All required fields completed
- A Recent Picture of Yourself to be uploaded in the Application
- Preferred Interview Dates Selected
- 2 Online Recommendations, to be completed by Sunday, May 18th, 2015 (click here)

Please note that an incomplete application may result in disqualification from the application process. *Please be sure to complete all six sections of the application. Your application is only complete once you press "SUBMIT".

After the application is complete, you will be contacted regarding your requested date of interview.

Have more questions? Contact Sami at ssteinavner@westsidejcc.org or (323)556-5207. The application period is open through May 18th, 2015.

Before you begin:

- The application takes approximately 20-30 minutes to complete.

- You will be asked to upload a recent photo of yourself (the photo cannot contain anyone else - just you - and should be no older than one year)

- We strongly recommend you complete the application in one session. However, if necessary, you are able to save what you have done and complete the form at a later time using the "Save Answers and Resume Later" button at the bottom of each page. Please note that if you choose this option, you will need to enter your email address so that our system can send you a personalized link to complete your application at a later time. Please ensure you enter a valid email address as for security reasons there is no way to retrieve the link at a later time and you will have to restart the application process.

- You will receive a confirmation email when you submit your application to confirm that it has been received by our office. If you do not receive this email, please contact Sami at ssteinavner@westsidejcc.org or (323)556-5207.

Name
Please enter your primary email address
Address

Additional Applicant Information

Are you a US Citizen?
Is one or both of your parents Israeli-born?
How do you identify Jewishly?
Please enter the name of your synagogue, or enter "Unaffiliated" if you do not belong to a synagogue
Dietary Requirements/Preferences
Please select all that apply

Parent/Guardian Information

Please enter details of your parent(s) / guardian(s)

Parent/Guardian 1
Relationship to Applicant
Does Parent/Guardian 1 share the same home address as applicant?
Parent/Guardian 1 Address:
Parent/Guardian 2
Relationship to Applicant
Does Parent/Guardian 2 share the same home address as applicant?
Parent/Guardian 2 Address:
Are any of your siblings Diller Alumni?
Please list the names and ages of each of your siblings
Please list the names and ages of each of your siblings

Education & Extracurricular Information

Applicants must CURRENTLY be in Grade 9 or 10 to be eligible to participate in the program next year (in Grade 10/11).
Do you have any Jewish School experience?
(includes primary, secondary, or supplementary/after-school)
(e.g. "Bialik Hebrew Day School: Grades 1-6")
Do you have any camp/youth group experience?
(includes overnight and day camp, and any youth groups)
(e.g. Camp Kadimah - 2010, BBYO - 2012, etc.)

Leadership Experience

Extracurricular

Have you ever traveled as part of a student group/delegation WITHOUT your parents/family?

Volunteer Experience

(e.g. ABC Hospital Volunteer - 2010)

Short Answer Questions

Please complete the following Short Answer questions to the best of your ability

Complete each of the statements below:

Photo & Agreement

Upload a photo of yourself below. Make sure it is a photo of you only.
No File Chosen
File uploads may not work on some mobile devices.

References

References should be from non-related adults who can attest to your character and leadership skills. Personal friends are also not acceptable. One letter must be from a school official or teacher. The references you list must complete our online reference response form found on our website (www.dillerla.org) or accessible HERE.

 

Who should we be expecting references from?

Name (Reference 1)
Name (Reference 2)
Use your mouse or finger to draw your signature above

Interview Selection

You're Just About Done!

All applicants are required to participate in a group interview. The Interview Process includes a mini-workshop, a group interview & an individual interview. Please look carefully at interview locations as we will have interviews in BOTH the Valley and the City.


The Interview Options are:

- Wednesday, May 27 @ Westside JCC (5870 W Olympic Blvd, Los Angeles 90036) in the evening

- Sunday, May 31 @ Valley location TBD in the AM

- Wednesday, June 3 @ Valley location TBD in the evening

- Sunday, June 7 @ Westside JCC (5870 W Olympic Blvd, Los Angeles 90036) in the evening

Please select from one of the interview dates in the dropdown below and then hit submit.


Once you hit the submit button below, your application will be reviewed. 

In the meantime, should you have any questions, please don't hesitate to get in touch with Sami Stein Avner at ssteinavner@westsidejcc.org or (323)556-5207

 

The Diller Teen Fellows program is generously funded by the Helen Diller Family Foundation, a supporting foundation of the San Francisco Federation’s Jewish Community Endowment Fund.

wjcc_logoFNL.pngJFedinpartnershipwith.JPG

Save and Resume Later
Progress
Cancel
Confirm