Coming Together

Jewish Michiana Coming Together

Bridging-The-Gap Presents: Coming Together: A way to match different people with similar interests. Get to know other Jewish individuals to help expand your personal circle.

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* 1. About You

Name:

Where do you live in the Michiana Area?

E-Mail Address

Best Phone Number

Which Jewish movement (if any) do you belong? (i.e.: Reform, Conservative, Orthodox, unaffiliated, etc.)

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* 2. Are you male or female?

Male

Female

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* 3. What is your age?

17 or younger

18-20

21-29

30-39

40-49

50-59

60 or older

Prefer Not To Answer

The following are different types of activities you may be interest in. Please first select whether you're interested in participating one-on-one or in a group; and second, please identify if you're interested in participating only, learning, and/or teaching/leading the activity. You may choose as many options as you'd like.

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* 4. Active/Sports

	One-On-One	Group	Participation only	Want to Learn	Can Lead/Teach
Walking	Walking One-On-One	Walking Group	Walking Participation only	Walking Want to Learn	Walking Can Lead/Teach
Jogging/Running	Jogging/Running One-On-One	Jogging/Running Group	Jogging/Running Participation only	Jogging/Running Want to Learn	Jogging/Running Can Lead/Teach
Hiking	Hiking One-On-One	Hiking Group	Hiking Participation only	Hiking Want to Learn	Hiking Can Lead/Teach
Tennis	Tennis One-On-One	Tennis Group	Tennis Participation only	Tennis Want to Learn	Tennis Can Lead/Teach
Golf	Golf One-On-One	Golf Group	Golf Participation only	Golf Want to Learn	Golf Can Lead/Teach
Swimming	Swimming One-On-One	Swimming Group	Swimming Participation only	Swimming Want to Learn	Swimming Can Lead/Teach
Basketball	Basketball One-On-One	Basketball Group	Basketball Participation only	Basketball Want to Learn	Basketball Can Lead/Teach
Softball	Softball One-On-One	Softball Group	Softball Participation only	Softball Want to Learn	Softball Can Lead/Teach
Sand Volleyball	Sand Volleyball One-On-One	Sand Volleyball Group	Sand Volleyball Participation only	Sand Volleyball Want to Learn	Sand Volleyball Can Lead/Teach
Soccer	Soccer One-On-One	Soccer Group	Soccer Participation only	Soccer Want to Learn	Soccer Can Lead/Teach
Ultimate Firsbee	Ultimate Firsbee One-On-One	Ultimate Firsbee Group	Ultimate Firsbee Participation only	Ultimate Firsbee Want to Learn	Ultimate Firsbee Can Lead/Teach
Dance	Dance One-On-One	Dance Group	Dance Participation only	Dance Want to Learn	Dance Can Lead/Teach
Arobics/Yoga/Zumba	Arobics/Yoga/Zumba One-On-One	Arobics/Yoga/Zumba Group	Arobics/Yoga/Zumba Participation only	Arobics/Yoga/Zumba Want to Learn	Arobics/Yoga/Zumba Can Lead/Teach

Other (please specify)

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* 5. Games & Clubs

	One-on-One	Group	Participation only	Want to Learn	Can Lead/Teach
Card Games (Gin, Poker, Bridger, Euchre, etc.)	Card Games (Gin, Poker, Bridger, Euchre, etc.) One-on-One	Card Games (Gin, Poker, Bridger, Euchre, etc.) Group	Card Games (Gin, Poker, Bridger, Euchre, etc.) Participation only	Card Games (Gin, Poker, Bridger, Euchre, etc.) Want to Learn	Card Games (Gin, Poker, Bridger, Euchre, etc.) Can Lead/Teach
Board Games (Apples to Apples, Catchphrase, Monopoly, Risk, Charades, etc.)	Board Games (Apples to Apples, Catchphrase, Monopoly, Risk, Charades, etc.) One-on-One	Board Games (Apples to Apples, Catchphrase, Monopoly, Risk, Charades, etc.) Group	Board Games (Apples to Apples, Catchphrase, Monopoly, Risk, Charades, etc.) Participation only	Board Games (Apples to Apples, Catchphrase, Monopoly, Risk, Charades, etc.) Want to Learn	Board Games (Apples to Apples, Catchphrase, Monopoly, Risk, Charades, etc.) Can Lead/Teach
Video Games (Halo, Dance Revolution, Bowling, Guitar Hero, etc.)	Video Games (Halo, Dance Revolution, Bowling, Guitar Hero, etc.) One-on-One	Video Games (Halo, Dance Revolution, Bowling, Guitar Hero, etc.) Group	Video Games (Halo, Dance Revolution, Bowling, Guitar Hero, etc.) Participation only	Video Games (Halo, Dance Revolution, Bowling, Guitar Hero, etc.) Want to Learn	Video Games (Halo, Dance Revolution, Bowling, Guitar Hero, etc.) Can Lead/Teach
Roll Playing Games (Dungeons & Dragons, HeroClix, Brave New World, etc)	Roll Playing Games (Dungeons & Dragons, HeroClix, Brave New World, etc) One-on-One	Roll Playing Games (Dungeons & Dragons, HeroClix, Brave New World, etc) Group	Roll Playing Games (Dungeons & Dragons, HeroClix, Brave New World, etc) Participation only	Roll Playing Games (Dungeons & Dragons, HeroClix, Brave New World, etc) Want to Learn	Roll Playing Games (Dungeons & Dragons, HeroClix, Brave New World, etc) Can Lead/Teach
Strategy Games (Chess, Backgammon, Mahjong, Etc.)	Strategy Games (Chess, Backgammon, Mahjong, Etc.) One-on-One	Strategy Games (Chess, Backgammon, Mahjong, Etc.) Group	Strategy Games (Chess, Backgammon, Mahjong, Etc.) Participation only	Strategy Games (Chess, Backgammon, Mahjong, Etc.) Want to Learn	Strategy Games (Chess, Backgammon, Mahjong, Etc.) Can Lead/Teach
Book Group (Fiction, Non-Fiction, Sci-Fi, Romance, etc.)	Book Group (Fiction, Non-Fiction, Sci-Fi, Romance, etc.) One-on-One	Book Group (Fiction, Non-Fiction, Sci-Fi, Romance, etc.) Group	Book Group (Fiction, Non-Fiction, Sci-Fi, Romance, etc.) Participation only	Book Group (Fiction, Non-Fiction, Sci-Fi, Romance, etc.) Want to Learn	Book Group (Fiction, Non-Fiction, Sci-Fi, Romance, etc.) Can Lead/Teach
Movie Club (Action, Drama, Comedy, Classics, etc.)	Movie Club (Action, Drama, Comedy, Classics, etc.) One-on-One	Movie Club (Action, Drama, Comedy, Classics, etc.) Group	Movie Club (Action, Drama, Comedy, Classics, etc.) Participation only	Movie Club (Action, Drama, Comedy, Classics, etc.) Want to Learn	Movie Club (Action, Drama, Comedy, Classics, etc.) Can Lead/Teach
Language Club (Yiddish, Hebrew, French, etc.)	Language Club (Yiddish, Hebrew, French, etc.) One-on-One	Language Club (Yiddish, Hebrew, French, etc.) Group	Language Club (Yiddish, Hebrew, French, etc.) Participation only	Language Club (Yiddish, Hebrew, French, etc.) Want to Learn	Language Club (Yiddish, Hebrew, French, etc.) Can Lead/Teach

Iif you have one, please Indicate Specific Game Preference of your above checked (such as "poker", if you're only interested in playing poker).

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* 6. Creative Art

	One-on-One	Group	Participation only	Want to Learn	Can Lead/Teach
Painting & Drawing	Painting & Drawing One-on-One	Painting & Drawing Group	Painting & Drawing Participation only	Painting & Drawing Want to Learn	Painting & Drawing Can Lead/Teach
Knitting & Crochet	Knitting & Crochet One-on-One	Knitting & Crochet Group	Knitting & Crochet Participation only	Knitting & Crochet Want to Learn	Knitting & Crochet Can Lead/Teach
Embroidery	Embroidery One-on-One	Embroidery Group	Embroidery Participation only	Embroidery Want to Learn	Embroidery Can Lead/Teach
Creative Writing	Creative Writing One-on-One	Creative Writing Group	Creative Writing Participation only	Creative Writing Want to Learn	Creative Writing Can Lead/Teach
Jewish or Ethnic Cooking	Jewish or Ethnic Cooking One-on-One	Jewish or Ethnic Cooking Group	Jewish or Ethnic Cooking Participation only	Jewish or Ethnic Cooking Want to Learn	Jewish or Ethnic Cooking Can Lead/Teach

Other (please specify type and if you can teach)

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* 7. Other Activities

	One-on-One	Group	Participation only	Want to Learn	Can Lead/Teach
Torah Discussion	Torah Discussion One-on-One	Torah Discussion Group	Torah Discussion Participation only	Torah Discussion Want to Learn	Torah Discussion Can Lead/Teach
Mitzvah Circle / Social Action	Mitzvah Circle / Social Action One-on-One	Mitzvah Circle / Social Action Group	Mitzvah Circle / Social Action Participation only	Mitzvah Circle / Social Action Want to Learn	Mitzvah Circle / Social Action Can Lead/Teach
Political Discussion (US and/or Israel)	Political Discussion (US and/or Israel) One-on-One	Political Discussion (US and/or Israel) Group	Political Discussion (US and/or Israel) Participation only	Political Discussion (US and/or Israel) Want to Learn	Political Discussion (US and/or Israel) Can Lead/Teach
Special Outings (Baseball Games, Museums, Theater, etc.)	Special Outings (Baseball Games, Museums, Theater, etc.) One-on-One	Special Outings (Baseball Games, Museums, Theater, etc.) Group	Special Outings (Baseball Games, Museums, Theater, etc.) Participation only	Special Outings (Baseball Games, Museums, Theater, etc.) Want to Learn	Special Outings (Baseball Games, Museums, Theater, etc.) Can Lead/Teach
Starbucks/Krispy Kreme Coffee Club	Starbucks/Krispy Kreme Coffee Club One-on-One	Starbucks/Krispy Kreme Coffee Club Group	Starbucks/Krispy Kreme Coffee Club Participation only	Starbucks/Krispy Kreme Coffee Club Want to Learn	Starbucks/Krispy Kreme Coffee Club Can Lead/Teach
Sporting Events (Superbowl Party, Watching Sporting Events on TV, Fantasy Leagues, etc.)	Sporting Events (Superbowl Party, Watching Sporting Events on TV, Fantasy Leagues, etc.) One-on-One	Sporting Events (Superbowl Party, Watching Sporting Events on TV, Fantasy Leagues, etc.) Group	Sporting Events (Superbowl Party, Watching Sporting Events on TV, Fantasy Leagues, etc.) Participation only	Sporting Events (Superbowl Party, Watching Sporting Events on TV, Fantasy Leagues, etc.) Want to Learn	Sporting Events (Superbowl Party, Watching Sporting Events on TV, Fantasy Leagues, etc.) Can Lead/Teach
Play Instruments / Musical Jam Session / Garage Band	Play Instruments / Musical Jam Session / Garage Band One-on-One	Play Instruments / Musical Jam Session / Garage Band Group	Play Instruments / Musical Jam Session / Garage Band Participation only	Play Instruments / Musical Jam Session / Garage Band Want to Learn	Play Instruments / Musical Jam Session / Garage Band Can Lead/Teach

Other (please specify)

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* 8. If you have Pre-Bar/Bat Mitzvah Aged Children, Would You Be Interested in New Play-dates / Play Groups?

Yes, One-on-One Play-dates

Yes, Play Groups: Participate Only

Yes, Play Group: Participate & Coordinate

Not Interested/No Children in that Age Group

List your child(ren): Name, Age, Sex

Thank You So Much for Sharing Your Interests!