Philadelphia -Diller Teen Fellows Reference Form 2020-2021

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Diller Teen Fellows

Reference Form 2020-2021

Please fill out the following form in order to serve as a reference for an applicant seeking to participate Philadelphia Diller Teen Fellows for the 2020-2021 school year.

Diller Teen Fellows is an intensive identity, leadership, and community service program, where students learn and work together in a variety of settings, including overseas. More information is available at the Diller Teen Fellows visit www.dillerteenfellows.org, or by contacting Darren Rabinowitz at drabinowitz@jewishphilly.org or 215.823.0823

Name of Applicant*

First Name

Last Name

Your Name*

First Name

Last Name

Agency & Title*

Your relationship to the applicant*

Your Phone*

Your Email*

Address

Address Line 1

Address Line 2

City

State

ZIP Code

The success of the program depends on the participants’ ability to: adjust to new environments and people; work and live cooperatively in an intensive group setting; maintain a sense of initiative and independence through positive energy and strength of character; creatively mobilize their peers to take action as future Jewish leaders.

While there is no single model of an participant, there are certain criteria that make a successful participant. Among those criteria are: emotional maturity and stability, openness to learning and new experiences, interpersonal skills, leadership potential, and creativity.

It is important that you describe the applicant as specifically and objectively as possible. Please share the candidate’s strengths and challenges. All information shall be kept confidential.

Thank you in advance for your help in identifying young leaders within our community.

Please answer the following questions: