Tools for Shuls Grant Application Survey

Thank you for your interest in the Tools for Shuls Measuring Success Program.
Please complete this application by Friday, December 16 2011. This form should only be completed once per synagogue.
The purpose of this form is to help assess the readiness of the synagogue to be a part of this program.

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* 1. Synagogue:

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* 2. Full Address

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* 3. Contact Person for this program

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* 4. Number of membership units:

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* 5. Synagogue Affiliation

Orthodox

Conservative

Reform

Reconstructionist

Other (please specify)

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* 6. Human Resources

Number of clergy

Number of professional staff

Number of administrative staff

Number of active board members

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* 7. Readiness Questions: Please rate the following.

	Very Much	Somewhat	A little	Not at all
Is the synagogue's professional leadership team open to strategic discussions for change?	Is the synagogue's professional leadership team open to strategic discussions for change? Very Much	Is the synagogue's professional leadership team open to strategic discussions for change? Somewhat	Is the synagogue's professional leadership team open to strategic discussions for change? A little	Is the synagogue's professional leadership team open to strategic discussions for change? Not at all
Is the synagogue's volunteer leadership team open to strategic discussions for change?	Is the synagogue's volunteer leadership team open to strategic discussions for change? Very Much	Is the synagogue's volunteer leadership team open to strategic discussions for change? Somewhat	Is the synagogue's volunteer leadership team open to strategic discussions for change? A little	Is the synagogue's volunteer leadership team open to strategic discussions for change? Not at all
My volunteer leadership has asked about measurable benchmarks	My volunteer leadership has asked about measurable benchmarks Very Much	My volunteer leadership has asked about measurable benchmarks Somewhat	My volunteer leadership has asked about measurable benchmarks A little	My volunteer leadership has asked about measurable benchmarks Not at all
My synagogue, using its current model, is financially sustainable for the forseeable future	My synagogue, using its current model, is financially sustainable for the forseeable future Very Much	My synagogue, using its current model, is financially sustainable for the forseeable future Somewhat	My synagogue, using its current model, is financially sustainable for the forseeable future A little	My synagogue, using its current model, is financially sustainable for the forseeable future Not at all

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* 8. E-mail Addresses

What % of members' e-mail addresses do you currently have?

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* 9. Do you have accurate e-mails for program participants who are not members?

Yes (all)

Yes (some)

None

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* 10. Please describe the working relationship between your Rabbi, Executive Director and Board in terms of division of responsibility.

Please list the contact information for all those that will be involved in this process. This should include at least one clergy, one professional staff and one board member.

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* 11. Contact 1

Name:

Position:

Phone #:

E-mail:

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* 12. Contact 2

Name:

Position:

Phone #:

E-mail:

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* 13. Contact 3

Name:

Position:

Phone #:

E-mail:

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* 14. Contact 4

Name:

Position:

Phone #:

E-mail:

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* 15. Contact 5

Name:

Position:

Phone #:

E-mail: