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Hillel Success Stories Intake Form

Welcome to Hillel Success Stories! This new Instagram account is a place to spotlight incredible ideas and innovations in the realm of student engagement, leadership, and experiences. Have a Hillel success story you want to feature? Please complete the intake form below and a member of the program team will reach out with more information.

1. Your Name: *This question is required.

2. Your Role: *This question is required.

Please enter an 'other' value for this selection. * This question is required.

3. Your Campus Hillel *This question is required.

4. Program Name: *This question is required.

5. Select the program format. *This question is required.

Please enter an 'other' value for this selection. * This question is required.

6. Program Start Date: *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

7. Program End Date: This question requires a valid date format of MM/DD/YYYY.

calendar

8. In 3-5 sentences, describe the program or initiative you want to showcase and celebrate with the Hillel community. *This question is required.

9. With which pillar of work does the program most closely align? *This question is required.

10. What were the top 3 student outcomes of the initiative?

Students... *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3
Felt a sense of belonging at Hillel	Rank Felt a sense of belonging at Hillel as 1 out of 3	Rank Felt a sense of belonging at Hillel as 2 out of 3	Rank Felt a sense of belonging at Hillel as 3 out of 3
Felt a sense of belonging within a Jewish campus community	Rank Felt a sense of belonging within a Jewish campus community as 1 out of 3	Rank Felt a sense of belonging within a Jewish campus community as 2 out of 3	Rank Felt a sense of belonging within a Jewish campus community as 3 out of 3
Were engaged in a micro-community at Hillel	Rank Were engaged in a micro-community at Hillel as 1 out of 3	Rank Were engaged in a micro-community at Hillel as 2 out of 3	Rank Were engaged in a micro-community at Hillel as 3 out of 3
Felt comfortable expressing their Jewish identity on campus	Rank Felt comfortable expressing their Jewish identity on campus as 1 out of 3	Rank Felt comfortable expressing their Jewish identity on campus as 2 out of 3	Rank Felt comfortable expressing their Jewish identity on campus as 3 out of 3
Reported confidence or new skills	Rank Reported confidence or new skills as 1 out of 3	Rank Reported confidence or new skills as 2 out of 3	Rank Reported confidence or new skills as 3 out of 3
Had the opportunity to lead, create or shape the program	Rank Had the opportunity to lead, create or shape the program as 1 out of 3	Rank Had the opportunity to lead, create or shape the program as 2 out of 3	Rank Had the opportunity to lead, create or shape the program as 3 out of 3
Were connected to the larger Hillel movement	Rank Were connected to the larger Hillel movement as 1 out of 3	Rank Were connected to the larger Hillel movement as 2 out of 3	Rank Were connected to the larger Hillel movement as 3 out of 3
Were connected to other students on campus	Rank Were connected to other students on campus as 1 out of 3	Rank Were connected to other students on campus as 2 out of 3	Rank Were connected to other students on campus as 3 out of 3
Increased their pride in being Jewish	Rank Increased their pride in being Jewish as 1 out of 3	Rank Increased their pride in being Jewish as 2 out of 3	Rank Increased their pride in being Jewish as 3 out of 3
Felt a sense of Jewish joy	Rank Felt a sense of Jewish joy as 1 out of 3	Rank Felt a sense of Jewish joy as 2 out of 3	Rank Felt a sense of Jewish joy as 3 out of 3
Deepened their Jewish network	Rank Deepened their Jewish network as 1 out of 3	Rank Deepened their Jewish network as 2 out of 3	Rank Deepened their Jewish network as 3 out of 3
Felt inspired to take on a leadership role	Rank Felt inspired to take on a leadership role as 1 out of 3	Rank Felt inspired to take on a leadership role as 2 out of 3	Rank Felt inspired to take on a leadership role as 3 out of 3
Strengthened their Jewish identity	Rank Strengthened their Jewish identity as 1 out of 3	Rank Strengthened their Jewish identity as 2 out of 3	Rank Strengthened their Jewish identity as 3 out of 3
Deepened their Jewish or Israel knowledge	Rank Deepened their Jewish or Israel knowledge as 1 out of 3	Rank Deepened their Jewish or Israel knowledge as 2 out of 3	Rank Deepened their Jewish or Israel knowledge as 3 out of 3

If there was a different impact of your program or initiative, please share it below.

11. How many students participated in this program or initiative? *This question is required. This question requires a valid number format.

12. Which best describes the program? *This question is required.

Please enter an 'other' value for this selection. * This question is required.

13. Was this program grant funded? *This question is required.

Please enter an 'other' value for this selection. * This question is required.

14. Would you have done the program without the grant funding? *This question is required.

14. Please include any supporting materials, such as photos, videos, flyers, or documentation, in a Google Drive folder. Share the folder link below, using the following naming convention: "HillelName_HillelSuccessStories" and be sure to adjust the sharing settings so that we're able to access the contents. *This question is required.

15. I grant Hillel International permission to use the provided materials in developing, publishing, and promoting content through Hillel Success Stories. *This question is required.

I agree