Diller Teen Awards

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Page 1 - Background Information

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

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First Name:

Last Name:

Email:

State:

Other:

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.

Will you be aged 13-19 years old on January 8, 2018?

Yes

Are you a resident of the US?

Yes

You have not been compensated for your services?

True

Do you self-identify as Jewish?

Yes

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

Tell us about yourself (a short personal bio):

Birthdate:

MM/DD/YYYY

Home Phone:

Mobile:

Parent/Guardian Names, First Last:

Street Address:

City:

Zip:

School Name:

School's City, State:

Year in School:

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

Project Title:

Imagine that you have 30 seconds to explain what your project does, who it serves and the main accomplishments. What are the key points you would make?

How did your project begin? Who/what inspired you to take action?

Please describe the goals of your project.

How does your project work? We'd like to know what you do in order to reach your goals.

Please describe your project's effect and impact to date (with detailed specifics).

Leadership

Please describe your leadership role in this project. What are your specific responsibilities? Do you manage others? What form does that management take?

How have you grown as a leader through this project?

What do you envision for your project going forward? Please include any plans you have to hand off leadership. If you do not have such plans, explain why they are not yet necessary.

Please describe your most notable accomplishment while working on the project:

Please describe one or more challenges you have faced working on the project:

Project Background

Are you the project founder?

Did your project/leadership build off an already existing project?

Does your project have a parent organization or any other organizational affiliations?

Is your project dedicated to raising funds/ volunteers/ resources/ awareness for an existing organization?

Please describe the parent/existing project and how your project/ leadership role relates to it:

Please share the related organization’s name / website / leader’s name / leader’s phone:

Length of Project

How long have you been working on your project--when did you start working on it?

Approximate starting date

How much time do you spend on your project?

Select preferred time period:

Engagement of Others

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

Do others (adults or teens) have a role in managing this project? If so, please list the name of each person and describe each of their roles, as well as your roles. Please specify if the person is another teen or an adult, and their relationship to you.

Finances, Donations, and Accounting

Did/do you raise funds to support this project?

If so, how?

How much money has been raised? (gross - before subtracting out expenses or payments to other organizations or individuals):

Do you contribute your fundraising to other organizations and/or individuals? Please describe, including dollar amounts:

Did/do you receive donations of goods or services?

Please describe the donations and how they were obtained:

How much do you estimate the donations have been worth?

Have you used any of the items noted above, or given them to other individuals/organizations? Please describe:

Did/does your project have expenses?

How much money has been spent, and what has it been spent on?

How are finances managed, and by whom?

Have you, or has anyone involved in your project, been compensated for work done in relation to the project? If so, what was the amount of compensation and what was it for?

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2018 Diller Awards Application Form

Page 1 - Background Information

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Page 3 - Additional Information

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2018 Diller Awards Application Form

Page 1 - Background Information

Page 2 - Project Information

Page 3 - Additional Information