Access to Power Fellowship reference form

Hello,

The individual who sent you this form is applying to participate in the Access to Power Fellowship, a six-month leadership development program for Jewish young adults with disabilities. The program focuses on community organizing skills, disability justice, and Judaism. Fellows participate in weekly training and coaching while doing community organizing work of their choice on a volunteer or professional basis.

We seek Fellows who can build strong relationships across lines of difference, be open to new ideas and constructive criticism, be strategic and creative, and be open to tension.

Please try to describe the applicant as concretely and specifically as possible. References that help us understand both the strengths and weaknesses of the applicant are most helpful. We especially appreciate examples and anecdotes that illustrate your experience with the applicant. Information will not be shared with the applicant.

Important: Please submit this form as soon as possible. The application deadline is November 6, 2020.

Thank you in advance for your time and care.

The JOIN for Justice Staff

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* 1. Your Name

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* 2. Title

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* 3. Organization

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* 4. Organization Location

City

State/Province/Region

Country

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* 5. Phone Number

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* 6. Email Address

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* 7. Applicant Name

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* 8. For how long and in what capacity have you known the applicant?

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* 9. What are the first three adjectives that come to mind to describe this person? Please explain (50-200 words suggested).

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* 10. What are some of this person's strengths related to community organizing (or related areas such as leadership and activism)? Please give concrete examples (50-200 words suggested).

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* 11. What do you think might be challenging for the applicant in their work as a community organizer or while participating in the Access to Power Fellowship? (50-200 words suggested)

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* 12. If you would like to provide any other relevant information about the applicant, please do so here.

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* 13. Please rate the applicant with respect to the following traits:

	Exceptional	Very Good	Good	Fair
Emotional Maturity	Emotional Maturity Exceptional	Emotional Maturity Very Good	Emotional Maturity Good	Emotional Maturity Fair
Flexibility	Flexibility Exceptional	Flexibility Very Good	Flexibility Good	Flexibility Fair
Dependability	Dependability Exceptional	Dependability Very Good	Dependability Good	Dependability Fair
Interpersonal Skills	Interpersonal Skills Exceptional	Interpersonal Skills Very Good	Interpersonal Skills Good	Interpersonal Skills Fair
Strategic Thinking Skills	Strategic Thinking Skills Exceptional	Strategic Thinking Skills Very Good	Strategic Thinking Skills Good	Strategic Thinking Skills Fair
Openness to Feedback	Openness to Feedback Exceptional	Openness to Feedback Very Good	Openness to Feedback Good	Openness to Feedback Fair

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* 14. Please explain any "Good" or "Fair" ratings you gave in Question 13:

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* 15. Overall Recommendation

Highly Recommend

Recommend

Recommend with Reservations

Do Not Recommend

Thank you for serving as a JOIN reference.

If you have any questions, please contact Allegra Heath-Stout at aheathstout@joinforjustice.org or 857-869-2057.