Wufoo
20/20 Judaism: Workshop Proposal Application
USCJ and the RA welcome your proposal to present at our 2019 convention in Boston, Massachusetts. From December 6-10, we will push each other to seek meaning together and see the Jewish future with a 20/20 Vision. Transforming the way communities grapple with critical topics requires that we bring diverse ideas into the room, even if it involves hearing things we typically avoid.
Application Deadline
Applications are due on Wednesday, May 1, 2019 at 5:00 pm Eastern Daylight Time.
Your Name
*
Title
First
Last
Suffix
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
----
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Bouvet Island
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo - Brazzaville
Congo - Kinshasa
Cook Islands
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard & McDonald Islands
Honduras
Hong Kong SAR China
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau SAR China
Republic of North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé & Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Barthélemy
St. Helena
St. Kitts & Nevis
St. Lucia
St. Martin
St. Pierre & Miquelon
St. Vincent & Grenadines
Sudan
Suriname
Svalbard & Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
U.S. Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Email
*
Phone Number
*
###
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###
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Additional information about you - Are you a (Check all that apply)
*
Member of a Conservative Synagogue?
Clergy Member or Professional at a Conservative Synagogue?
USY Alum(na)?
Nativ Alum(na)?
None of the above
Please tell us which congregation you belong to and/or which organization you represent.
Synagogue or Organization's Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
----
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Bouvet Island
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo - Brazzaville
Congo - Kinshasa
Cook Islands
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard & McDonald Islands
Honduras
Hong Kong SAR China
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau SAR China
Republic of North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé & Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Barthélemy
St. Helena
St. Kitts & Nevis
St. Lucia
St. Martin
St. Pierre & Miquelon
St. Vincent & Grenadines
Sudan
Suriname
Svalbard & Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
U.S. Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
How did you learn about the 2019 USCJ Convention?
*
Email communication from USCJ
Social media communication from USCJ
Visit to the USCJ website
Visit to the USCJ Convention website
Contact with my KRM (Kehilla Relationship Manager)
Other
If you checked "Other," please specify.
Did you attend the USCJ Convention in 2017?
*
Yes
No
Were you a presenter at the USCJ Convention 2017?
*
Yes
No
Your Proposal
Please describe your session from the standpoint of what participants will know, do and feel. All sessions must include tools for participants to take home and take action. Tell us what tools you will provide.
Proposed Session Title
*
Description of Session. (150-250 words) Be sure to explain:
1. How the session will be interactive and experiential
2. What tools and strategies participants will learn
3. How your session will help participants continue the work when they return home
*
Enter
150
to
250
words.
Currently Used:
0
words.
Workshop Description for Convention Program- Please write a blurb for your session as you would like it to appear on the convention mobile app. (100-150 Words)
*
Enter
100
to
150
words.
Currently Used:
0
words.
Here is a link to an article, video or another platform that would help advertise my session or thriving story from my congregation.
Name of Other Presenters (If Applicable)
I would be comfortable making my presentation in any of the following presentation formats (check all that apply)
*
Single Presenter Workshop
Multi-Presenter Workshop
Member of a Panel Discussion
Table Talk during a Convention Meal
Should your proposal be accepted, would you like to write a blog post or thought piece for the convention website?
*
Yes
No
Which day(s) would be best for you to present at the convention? (check all that apply)
*
Shabbaton- December 6-8, 2019
Sunday- December 8, 2019
Monday- December 9, 2019
Tuesday- December 10, 2019
Sometimes, we have multiple high quality applications for the same workshop topic. If someone proposes the same topic as you, would you be interested in us connecting you with them to combine sessions?
*
Yes
No
Should your proposal be accepted, would you like to record a video on YouTube or another format for the convention website?
*
Yes
No
This proposal is for a session to be attended exclusively by rabbis.
*
Yes
No
Presenter(s) Photo and Biography
USCJ requires that all presenters provide a photograph and biography in order to submit a completed application. Additional space is provided for additional photographs and biographies if the proposal includes multiple presenters.
Please upload a high-resolution photograph of yourself to be published on the convention website and in the convention brochure if your proposal is accepted.
*
Please write a short biography of yourself to be published on the convention website and in the convention brochure (50 Words or Less) if your proposal is accepted.
*
Maximum of
50
words.
Currently Used:
0
words.
Please upload an additional photograph if proposal includes multiple presenters.
Please upload an additional photograph if proposal includes multiple presenters.
Please write an additional biography to be published on the convention website if your proposal includes multiple presenters (50 Words or Less).
Maximum of
50
words.
Currently Used:
0
words.
Please write an additional biography to be published on the convention website if your proposal includes multiple presenters (50 Words or Less).
Maximum of
50
words.
Currently Used:
0
words.
Presenter Agreement
In submitting this proposal for the 2019 USCJ Convention, please note that you are agreeing to each of the following – please check each clause to confirm your agreement:
Should you be selected to be a presenter, you will be responsible for the costs of your transportation to/from the conference, your hotel stay, and payment of the full conference/Shabbaton registration fees (as applicable).
*
I Agree
USCJ (including its staff and volunteers) has full discretion to choose the workshops, presenters and participants in the 2019 USCJ Conference. There is no guarantee that this proposal will be accepted. It is understood that the presenters for the 2019 USCJ Convention will be selected on the basis of gender, sexual orientation, geography, backgrounds and institutional affiliations to allow USCJ to showcase a mosaic of outstanding leaders, professionals, and congregations.
*
I Agree
Should your proposal be selected, or should you be selected to be a presenter, the biography, picture description included with this proposal will be used in the convention program, and any of these materials may be edited by USCJ in its full discretion.
*
I Agree
Should your proposal be selected, or should you be selected to be a presenter, you agree that your image and presentation may be included in photos, videos and sound recordings produced prior to or during the USCJ convention, whether for purposes of promoting or reporting on the convention, or for such other use as USCJ may determine in its absolute discretion, and that such photos, videos and sound recordings may be used in print, on the Internet, or in other media produced by USCJ for publicity, promotional or any other purposes, without further permission.
*
I Agree
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