Resetting the Table Application Resetting the Table Application Name(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)1. What is your age range?(Required) 18-24 25-34 35-44 45-54 55-64 65 and over 2. What is your primary denominational affiliation?(Required)If you feel none of these words describe you, please leave a description in the comment box labeled “Other.” Reform Conservative Orthodox Unaffiliated Other If other, please explain3. Please list any leadership roles that you hold in the Jewish or broader Birmingham-area community (Boards, committees, etc.)(Required)4. Why do you want to participate in this workshop?(Required)5. How would you describe your general political leanings (as pertains to American politics)?(Required)We recognize that all political labels and categories are imperfect. Please choose the option that most applies to you. If you feel none of these words describe you, please leave a description in the comment box labeled “Other.” Very Conservative Conservative Moderate Liberal Very Liberal/ Progressive Other If other, please explain6. (Optional) Tell us more. Please use this space if you’d like to elaborate on your above answer.The below questions focus on your current views on the conflict in Israel. We understand that this is sensitive information that may not fit into easy categories. We ask that you answer honestly and to the best of your ability so that we can select a diverse group of participants, and we have provided open-ended space for elaboration. All answers will be viewed by the selection committee only and will remain completely confidential. 7. Please select the answer that best describes your current feelings towards the conflict in Israel(Required) Supportive with no reservations Supportive with concerns Not supportive of current policies Other If other, please explain8. On a scale of 1-5, how knowledgeable do you feel about the current conflict in Israel?(Required) 1 2 3 4 5 9. On a scale of 1-5, how knowledgeable do you feel about Israeli history?(Required) 1 2 3 4 5 (Optional) Tell us more. Please use this space if you’d like to elaborate on your answers for questions # 7-9.10. What are the primary places that you read or listen to the news (both for American politics and/or the current conflict in Israel)?(Required)11. How would you be most interested in participating in follow-up engagement post-program?*All workshop participants will be offered $118 to host a small-group Shabbat dinner Practicing skills in small groups with other participants Teaching these skills in a larger Jewish community program Hosting a Shabbat dinner for members of the Jewish community to learn more* Practicing these skills with non-Jewish family or friends Bringing these skills to existing leadership positions Getting involved in JCRC work Writing about my experience Other If other, please explain12. On a scale of 1-5, how confident do you feel having conversations across difference about Israel currently?(Required) 1 2 3 4 5 13. On a scale of 1-5, how confident do you feel having conversations across difference about general politics?(Required) 1 2 3 4 5 14. Are there any accommodations (disability or otherwise) you need us to provide in order for you to fully participate in this event? Please include dietary restrictions(Required)Untitled First Choice Second Choice Third Choice Untitled First Choice Second Choice Third Choice
