Please complete the form below. A member of the ShalomLearning team will contact you to confirm your setup, schedule, and next steps for the Winter Pilot.
Organization Information
Congregation / Organization Name*
Organization Type* SynagogueJCCDay SchoolSupplementary SchoolCampOther
City*
State*
Time Zone* Eastern (ET)Central (CT)Mountain (MT)Pacific (PT)Other – please specify in the notes below
Primary Contact Person
Full Name*
Title / Role*
Email Address*
Phone Number*
Your role in curriculum purchasing*
I am a decision maker about purchasing curriculumI am an influencer about purchasing curriculumOther (please describe below)
If you selected "Other," please describe:
If you are not the decision maker, we are happy to share the lessons with you. Please provide the name and contact information of the person we could contact about using our program in the future.
Name of decision maker:
Decision maker email:
Decision maker phone:
Winter Pilot Program Details
Which ShalomLearning offerings are you interested in?*
Hebrew (Prayer/Decoding)Jewish Values CurriculumOther / Not sure – please discuss with me
Please select up to two grades you would like to use in the Winter Pilot.
Grades you would like to use*
K1234567
Estimated number of students in the pilot*
Preferred start date for the Winter Pilot (approximate is fine)*
Prior ShalomLearning Experience
Have you or your community used ShalomLearning before?
I have used ShalomLearning at another siteOur current site has used ShalomLearning in the pastNo, this will be our first experienceNot sure
Referral & Communication
How did you hear about the ShalomLearning Winter Pilot?
Yes, please add me to the ShalomLearning newsletter.
Which school or colleague referred you?
Additional Information
Anything else we should know about your community, schedule, or goals for the Winter Pilot?
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