Hineni Fellowship Nomination Form

The Hineni Fellowship is a national, one-year Jewish leadership development fellowship that educates, inspires, and empowers LGBTQ Jewish leaders to become change-makers and innovators in the Jewish community. Hineni alumni go on to seek and attain positions of engagement, impact, and influence in the Jewish community locally, nationally and globally.

If you know of someone who would make a valuable addition to the program, please nominate them here.

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* 1. Please include your information:

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

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* 2. Please include your affiliation:

Your institution/organization

Your title/position

Nominee Information

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* 3. Nominee:

Name

Age

Gender

Email Address

City

Phone Number

Hineni Fellowship Nomination Form

Question Title

* 1. Please include your information:

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* 2. Please include your affiliation:

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* 3. Nominee:

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* 4. Briefly indicate in what capacity you know the nominee:

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* 5. Please describe the nominee’s leadership potential in your community: