Connecting @ Home Series – Host Application
Introducing 'Connecting @ Home Series': a brand-new way for Americans & Israelis to form a community, share an experience, & be #BetterTogether.

Each session, of this 4-part series (with a potential 5th "reunion" session), lasts roughly 60 minutes. There will be a training session on Monday, May 18 in the AM. Each session will require a few minutes of "prep work" before and and after.

If you are applying to be a host, you are someone who is a...

- Strong facilitator with proven experience
- Natural connector of people – this is all about building new community
- "Pusher" – you know the line between pushing people outside their comfort zone and being uncomfortable
- Fun! This requires someone who can bring the fun to a new group
First Name: *
Your answer
Last Name: *
Your answer
Email Address: *
Your answer
Phone Number: *
Your answer
What city & state are you located in? *
Your answer
Have you ever gone on a Birthright Israel trip with Shorashim before? *
Are you currently?
How were you raised?
As hosts, facilitation is really important to build these communities. Please tell us about a time that you successfully facilitated a conversation with a group. *
Your answer
Timing & Duration
Each session of the series should be about 60 minutes. These sessions will take place four times; there is the option to have two sessions per week through our two-week program or one session a week through our four four-week program.
Which would you prefer? *
Which times would work for you for our weekly or biweekly sessions? If you selected the twice per week option, please make sure to select times on both days. *
Please check all that apply
Would you be interested in staffing a Birthright Israel experience with Shorashim in the future? *
About You
While putting the groups together we will take into consideration different demographics/interests of the participants, please let us know a little bit about you!
Which of the following describes you? *
What's your Profession? *
Which would you like us to keep in consideration while forming your grouping? (Please note these are not guaranteed) *
Is there someone you think we should reach out to who would be a good fit of this program (as either a host or participant)? Put their name, email, and contact info below. *
Your answer
If you are not a host for this program, would you be interested in joining as a participant? *
Privacy Policy
By submitting this form, I agree to the terms and conditions contained by Shorashim's audio and video recording policy.
The #BetterTogether program is designed as a platform for sharing ideas and activities. Shorashim is not responsible for the ideas and thoughts expressed, the content provided, or the safety of any activities modeled during #BetterTogether programs. Consult a doctor or medical professional prior to engaging in any physical activities, and ensure adult supervision of any children participating in activities.
Never submit passwords through Google Forms.
This form was created inside of Shorashim. Report Abuse