Gala – Test | The Bronfman Fellowship - The Pluralistic Leadership program for Jewish teens

Who are you?*

I'm interested in applying/ learning more about The Bronfman Fellowship
I'm nominating someone for The Bronfman Fellowship

Nominator Name*

First Last

Nominator Email*

Prospective Applicant Information

Prospective Applicant Name*

First Last

Prospective Applicant Email*

Prospective Applicant Gender (optional)

Prospective Applicant Phone Number (optional)

Prospective Applicant Address (optional)

City State

High School (optional)

Type of school (optional):

Public
Private/Not Jewishly affiliated
Private/Jewishly affiliated

In the fall of 2024, prospective applicant will be in:

11th grade (2025 cohort)
10th grade (2026 cohort)
9th grade (2027 cohort)

How did you hear about us?

Is there anyone else you think would be interested in learning more about the Fellowship?

Please provide their name(s) and email(s) below. If you would like to nominate someone else, please go to https://bronfman.org/become-a-fellow/for-parents-educators/interest-nomination-form/.

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Gala – Test

Applicant and Nominator Form

Prospective Applicant Information