Project Etgar Pilot School Application 2008-2009

General Information

Synagogue Name
Synagogue Address
Synagogue Phone Number
School Phone Number
Synagogue Fax Number
School Fax Number
Educational Director's Name
Assistant Educational Director's Name
Synagogue Email Address
School Email Address
Rabbi's Name
Name(s) of middle school teachers participating in pilot program:

To Be Completed by Educational Director

I will be available to attend Project Etgar training sessions:

Wednesday, January 30, 2008 Skokie , IL (following the JEA Conference)	Yes No
Tuesday, July 15 – Friday, July 18, 2008 – Jewish Theological Seminary, New York	Yes No
I will inform my potential Project Etgar teachers about July training as early as possible so that they can reserve the dates and plan to attend	Yes No

School Enrollment

Grade	Current Enrollment 2007/2008	Projected Enrollment 2008/2009
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth

Current School Schedule: Sixth, Seventh and Eight Grades

Please complete the chart below. In the days of the week section, indicate the times of classes. If you have more than one section on different days please show it on the chart.

	Days/Week	Hours/Week	SUN	MON	TUE	WED	THU	FRI	SHABBAT
Example: 6th grade (Sec 1)	3	6	9-11 AM		4-6 PM		4-6 PM
6th grade (Sec 2)	3	6	11 AM - 1 PM	4-6 PM		4-6 PM
6th grade
7th grade
8th grade
Special Programs
Hebrew Curriculum/Text Books
Other
Does your school have a preschool?				Yes No
Is the preschool operated under synagogue auspices?				Yes No
Is synagogue membership a prerequisite for enrollment in the preschool?				Yes No
Is synagogue membership a prerequisite for enrollment in the religious school?				Yes No

Please provide the following (feel free to type/paste responses into gray box or to attach a separate piece of paper):

Short Biography and/or Resume (including educational background, contractual obligations, and length of service) of:
Current Educational Director
Current Assistant Educational Director, Head Teacher and/or Middle School Coordinator if involved in Project Etgar

Short Statement From:
Rabbi
President of congregation or board of education chairperson describing his/her commitment to this project.

A 250 word essay to be completed by the Educational Director which includes the following:

1. Tell us about your school
2. How will you benefit from Project Etgar?
3. How might Project Etgar benefit from your participation?

Disclosure Statement

We have reviewed all the materials associated with Project Etgar. We are willing to test the entire program (the new middle school curriculum, teacher training, research, parent meetings, etc.) We also know that there are costs associated with this program and we are willing to assume them. We understand that the costs provided in this proposal are estimates and we will support the program financially within reason.

Signed by:

Rabbi
President of the Congregation
Educational Director

Please complete this application as soon as possible. While applications are due December 21, 2007, our process of rolling admissions will enable you to hear from us prior to January. We will notify you of acceptance within 2 weeks of receiving your application.

By submitting this form, you will be sending your school's information to Project Etgar. Your application will be sent to the USCJ Department of Education, and we'll be in touch with you with further information.