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Applications for the 2018 awards
are now open!
Deadline: January 8, 2018

Looking to nominate a teen?

Visit the Nomination Form.

Have you been asked to be a reference for an applicant?

Visit the Recommendation Form.

2018 Diller Awards Application Form

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Page 1 - Background Information

Part 1 - Background Information
Part 2 - Project Information
Part 3 - Additional Information

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Background & Eligibility
The Diller Teen Tikkun Olam Awards recognize Jewish teens in the United States who have demonstrated remarkable leadership and initiative in projects that embody the values of tikkun olam, “repairing the world."

A complete application packet for the 2018 awards requires an application form submitted by the teen, and two recommendations submitted on the teen's behalf (2 references OR if already nominated, 1 additional reference).

If you can answer "yes" to the following 4 questions, you are eligible for the award. 
Teens are not eligible for the Award if they have a sibling who has received a Diller Teen Tikkun Olam Award in the preceding five years.
Your Information


MM/DD/YYYY









Page 2 - Project Information

Please note the varied word limits indicated for each question, which are tracked for you by the word counter below the field.

About Your Project






Leadership





Project Background






Length of Project

Approximate starting date


Engagement of Others
Many teens are assisted by others in bringing their projects to life and/or making them successful:

Finances, Donations, and Accounting












Page 3 - Additional Information

Note: At least one recommendation should come from someone with direct knowledge of/involvement in your project.


Your Nominator




Reference #1




Reference #2






Outside Volunteering

Jewish Connection


If not applicable, write N/A.

If not applicable, write N/A.

If not applicable, write N/A.
Additional Information






Additional Documents (Optional)
It is often helpful to see primary organizational files such as event schedules, fundraising/budgeting spreadsheets, etc.

Before attaching files here, please save the document as "your full name - short description" for example: "Golda Meir - budget"
Your short description should not exceed twenty five characters.

Administrative Note: In some cases, staff may contact your references, you, or others familiar with your project for additional information.
Miscellaneous Information
Your answers to questions in this section are for office use and will not be forwarded to the committee.
Teens who have created and co-led with others are welcome to apply individually for the Tikkun Olam Award. In such cases, each applicant will be considered and evaluated separately, and no more than one applicant will be chosen as an award recipient.



Confirmations

The Diller Teen Tikkun Olam Awards will only text regarding the completion of this application.

By checking the boxes below, I confirm I understand that, if selected as a recipient:





You will receive a confirmation email upon submission. If you do not receive an email, please recheck that this form has no error alerts and contact us at 415-512-6432.

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