The Gina Freeman Shomrei HaAdam V’Ha’Adamah Award
Please complete the application form below and submit your completed form with the pictures requested by Monday April 15, 2019. If you have any questions please email Kerry Selfinger ( or call 614-939-5311).

Thank you, we are excited to hear about the great work you are doing!

First Name *
Last Name *
Phone Number *
Email *
Address *
City *
State *
Zip *
Last year attended at Columbus Jewish Day School *
Please share in 200-400 words an initiative/s in which you took a leadership role over the past year, that stems from a significant passion you have for serving humanity/Adam and/or protecting HaAdamah/the earth. (Please include any ways in which you have helped make the world a better place through love for the environment and caring for other people; and/or any responsibility you have taken for guarding humanity and the earth through volunteering, making monetary or non-monetary donations, utilizing your talents in any ways that help repair different corners of the world, locally or globally; and/or how you have demonstrated strong social-emotional caring of people of all ages that helps bring wholeness and dignity to others.)
Please attach a current head shot picture of yourself, and 1-3 photos of yourself engaged in the work you described.
Please share 2-3 ways in which the leadership role/s you describe above have helped humanity and/or helped to protect the earth.
Reflecting on your time as a student at CJDS, please describe one or more experiences you had at the school (could be an assignment, class unit/curriculum, inspiration from a teacher, club, or program, etc.) in which you recall your awareness of the importance of making a difference to humanity and/or the earth. (What was the experience, how did it make you feel and think, and how do you think it raised your awareness about Adam and/or HaAdamah?)
If received, towards which middle school, high school, or post-graduate program will you use the award? (please include a link to the program or school if possible)
What CJDS alumni events or programming would you like the school to organize for you and your class, and at what time of the year would that programming be most appealing?
If named the awardee, will you be available to attend the Award Presentation at CJDS on Thursday May 23, 2019, at CJDS Arts Night, 6:30-8pm? (Attendance is preferred but not mandatory). *
If awarded, I grant permission to CJDS to publish and share publicly information and photos that I have shared within this application. *
Watch the CJDS video here!
Thank you for applying! We will announce the recipient of the award by Friday May 3, 2019. Whether you are selected or not, we look forward to being in touch with you!
Never submit passwords through Google Forms.
This form was created inside of - Terms of Service