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The application deadline for the 2020 Awards is January 8th, 2020.

Looking to nominate a teen?

Visit the Nomination Form.

2020 Diller Teen Tikkun Olam Awards Application

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Page 1 - Background Information

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." 

Directions:

All application questions should be completed by teen applicants.

We recommend drafting and saving long form answers prior to submitting online.

Please see this .pdf file of the application.

For more information or support: [email protected].

To use the Save and Resume feature
Before saving your form, please make sure you have filled out each of the four fields in this section. Then you can use the "Save my progress and resume later" feature. Please make sure to note your password so you can easily access your saved form.





Eligibility
If you can answer "yes" to the following 4 questions, you are eligible to apply 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











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





Goals/Metrics
Please briefly describe the impact of your project (a list or short phrase is sufficient):







Leadership











Project Background/Origin

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 can be selected as an award recipient.



















Length of Project

MM/DD/YYYY

(hours per week)

Support/Engagement of Others

Many teens leaders are assisted by others in bringing their projects to life and/or making them successful. Responses from leaders working as individual contributors as well as within participatory groups are welcome:



Finances, Donations, and Accounting






Ex.) .doc, .docx, .xls, .xlsx, .csv, .pdf, .jpg, .jpeg, etc. Google drive attachments not compatible.





Page 3 - Additional Information

Outside Volunteering / Additional Information



If not applicable, write N/A

If not applicable write N/A

Additional Documents (Optional)
If you feel there are other materials you would like the committee to consider along with you application, please include those here. Accepted formats include: .doc, .docx, .xls, .xlsx, .csv, .pdf, .jpg, .jpeg, .png. Google drive attachments not compatible.

It is often helpful to see fundraising/budgeting spreadsheets, news articles, etc. If you plan events or offer a curriculum, please include event schedules and key curricular materials.

Attachment(s) must include your name in the document title so we are able to link it to your application.
Please save the document as "your full name -short description"
- For example: "Golda Meir - Curriculum"  
Your short description should not exceed twenty-five characters. 





Demographic Information

If not applicable, write N/A

If not applicable, write N/A

If not applicable, write N/A.
References

All applicants must provide the names and contact information of three people who know and can speak to your leadership within your project. 

Please list the individuals after you have their permission. We MAY contact all or none, to provide a confidential reference.

Note: In some cases, staff may contact you or others familiar with your project for additional information.

All applicants are weighted equally, with or without a nomination.
Reference 1





Reference 2





Reference 3 (if not nominated)





Nominator (if nominated)





Miscellaneous Information
Your answers to questions in this section are for office use and will not be forwarded to the committee.


Confirmations

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


By checking the boxes below, I confirm that, if selected as a recipient, I accept the following requirements:





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 before navigating away from this page.