Staff: Baseline Engagement Assesment

Please fill out this survey after an initial 1:1 with a community member

Your Name(Required)

Community Member Name(Required)
Is this person a new or pre-existing relationship?(Required)
Date of Conversation(Required)

Jewish Friendships

Does this community member have Jewish friends?(Required)
Is this community member interested in or seeking new or deeper Jewish friendships?(Required)

Personal/Home-Based Jewish Practice

Examples:
• Home Shabbat rituals
• Home holiday celebration
• Following Israel/Jewish News closely
• Listening to Jewish podcasts
• Reading Jewish Books - including to/with children
• Chevrutah learning
• Listening to Jewish music
Does this community member integrate Jewish rituals, celebration, or learning into their lives and/or into their families' lives?(Required)
Is this community member interested in or seeking to increase the frequency of their personal Jewish practice?(Required)
Does this community member know where to access resources to build their personal Jewish practice?(Required)
Does this community member host Jewish experiences for others?(Required)
Examples: Host a Shabbat dinner, Invite people to your Sukkah, Host a Seder

Jewish Communal Connections

Examples:
• Synagogue membership, attendance, involvement
• School or camp events (as an adult participant)
• Associated/Associated System involvement
• Participants in Network Events
• Committee or Board involvement at a Jewish organization
Does this community member have AT LEAST ONE Jewish community organization where they FEEL AT HOME?(Required)
(at and beyond the Jewish organization they are most connected to, if applicable)
Is this community member INTERESTED IN PARTICIPATING IN MORE Jewish communal gatherings?(Required)
Does this community member KNOW HOW TO ACCESS Jewish communal gatherings?(Required)
Does this community member hold a VOLUNTEER OR LEADERSHIP ROLE in a Jewish communal organization?(Required)
Examples:
• Serve on or chair a committee or board of a Jewish communal organization
• Frequent hands-on volunteering for a Jewish organization
• Fundraiser for a Jewish organization

Additional Information

Did this community member share that they had recently experienced or are experiencing any life cycle events or moments of transition?(Required)
examples could include: recent death in the family, preparing for child's b'mitzvah, recent or planned move or job change, etc.