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Interest/Referral Form

Hartman Teen Fellowship - Cohort 5, 2026-27

Instructions


Thank you for your interest in the Hartman Teen Fellowship. You can read more about the Fellowship here. You can use this form to tell us about your own interest in the program or to refer someone else to the program.  


After you submit this form we will reach out to you or the teens you referred with an invitation to complete an application.


Applications will open on March 2nd, 2026. Applications are due April 15th, 2026. 


Please contact Jesse Steinman, Manager of Teen Community & Engagement, with any questions at jesse.steinman@shalomhartman.org.


Your Information
Internal Note


In this section - the interested fellow information

Name


Contact


Location










School Information

Please check the box if you don't see your school name on the list below



Hartman Connection

Choose the most relevant answer


max. 250 words
Your Information





Location










Fellowship Candidate Information



Location










School Information

Please check the box if you don't see your school name on the list below




Choose the most relevant

This program is highlighted by 3 main values:
1) Commitment to Judaism and the Jewish People
2) Intellectual curiosity 
3) Positive contribution to our learning community 

Fellowship Candidate 2 Information



Location










School Information

Please check the box if you don't see your school name on the list below




Choose most relevant

This program is highlighted by 3 main values:
1) Commitment to Judaism and the Jewish People
2) Intellectual curiosity 
3) Positive contribution to our learning community 

Salesforce IDs for participant records
Program ID - Insert Program ID here as DEFAULT VALUE