Project Hineyni Involvement Form
Required Required Question(s)

Please complete the following survey. Your responses to this survey are not a commitment to perform these services at any specific time, but rather your agreement to be called upon by Project Hineyni if your assistance is needed.

If you or someone you know is in need of aid, please contact Chair Laura Stusser-Mcneil or Program Director Alysa Rosen. You may also call the Temple at (206) 525-0915. All responses, as well as all requests for support, will be kept confidential.

 
1.

Please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:

2.

When a member is sick or has had a loss in their family, I would be willing to:
Provide a meal
Call the family
Visit the family at their home
Visit the family in the hospital
Other  
3.

When a congregant gives birth or adopts a child, I would be willing to:
Bake or buy a Challah for the family
Deliver a Challah to the home
Call to wish them Mazel Tov
4.

We have a number of members who are homebound and could use ongoing support. Please check what you would be willing to do:
Shop for food or run an errand
Call to see how they are doing
Visit at a mutually agreeable time
Provide a ride to Temple Beth Am
Provide a ride to a medical appointment
Other  
5.

Temple Beth Am would like to offer trainings on how to visit the sick, make a shiva call, and more. Would you be interested in participating?
Yes
Not at this time
I have an idea for a training
I, or my organization, could help facilitate a training
6.

Providing a meal is a great way to say we are thinking of you. The Temple would be willing to open up our kitchen once a month and invite members to cook together for those in need. Would you be interested in participating?

Yes, please!
Yes, and I could help with shopping
No, but I could help in another way
7.

If the Temple provided cards and postage, would you be willing to send a card to a congregant?
Absolutely, tell me more
Not at this time
Required 8.

What is the best way to reach you during the day?
Work phone
Home phone
Cell phone (please provide in space below)
Email Address
  • Comment:

  • 500 characters left.
Required 9.

What time of day is the best time to reach you?
Mornings
Business Hours (9 am - 5 pm)
Evenings
Other  
  • Comment:

  • 500 characters left.