Community Impact Network Application

Applications for the CIN Plus cohort are NOW OPEN. Please fill out the form below.

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Name*

First Last

Phone*

Email*

Date of Birth*

Tell us about yourself.*

Please share your current professional role, community involvement, and any personal or professional experiences that have shaped your leadership journey.

What local community issue are you most passionate about and why?*

Describe a time when you made a positive impact in your community.*

What was the situation, what role did you play, and what did you learn from the experience?

Why are you interested in this leadership cohort program?*

What do you hope to gain from the experience, and how do you envision applying what you learn?

CIN Plus requires attendance at one Sunday retreat and five evening cohort sessions. Are you aware of any scheduling conflicts or other commitments that may affect your ability to participate fully?*

Would childcare for the Sunday retreat make it easier for you to participate?*

Yes

If yes, please list the age(s) of the child(ren) who would require childcare.*

What leadership roles have you held—professionally, as a volunteer, or in the community?*

Cohort sessions will be held on weekday evenings (Monday–Thursday). Which evenings generally work best for your schedule? (Select all that apply.)*

Monday

Tuesday

Wednesday

Thursday

Participant Fee

To help sustain the high-quality programming and community engagement opportunities we provide, this leadership cohort includes a participation fee of $1,000, due prior to the start of the program.

This fee contributes to:

Program materials and curriculum
Expert facilitators
Delicious kosher dinners
Attendance to JFSLA’s Annual Gala

Community Impact Network Application

Applications for the CIN Plus cohort are NOW OPEN. Please fill out the form below.

Participant Fee

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