Welcome to the Unity - Mothers of Lone Soldiers Trip.

Please complete the information below.

Upload your photo

MM/DD/YYYY

Cell Phone

Work Phone

Email

Your Lone Soldier

This trip is geared toward mothers of lone soldiers.

Are you a former, current, or future Mother of a Lone Soldier? (check all that apply)

FormerCurrentFuture

Tell us about your experience as a mother of a lone soldier.

Employment Info

What activities, hobbies and organizations (including Jewish organizations) are you involved in? Please describe your participation in them.

How often have you volunteered for a Jewish organization in the last two years?

Have you held a professional role in a Jewish organization in the past ten years?

Have you attended a Jewish conference in the past five years?

The Momentum experience is designed primarily for women who are not highly engaged in Jewish life and Jewish ritual observance.

How often do you participate in online conversations about Judaism and being Jewish?

In the past 3 months, how often did you mark Shabbat in a way that makes it meaningful to you?

In the past 3 months, how often did you light Shabbat candles?

Which best describes your synagogue experience in the past 3 months?

How often did you engage in Jewish learning this past year?

Did you host or attend a Passover Seder in the past three years?

What is your current Jewish affiliation?

Please share any interesting stories from your background in relation to your experience with Judaism or your Jewish identity:

Have you been to Israel before?

YesNo

If so, how many times were you in Israel in the past ten years?

Did you participate in a Birthright trip?

YesNo

Do you currently have a child (17 or younger) on an Israel program, or have you in the past?

YesNo

How often do you:

Go to Jewish film festivals or seek out Jewish films

Actively access websites from or about Israel

Read Jewish newspapers or seek out Jewish news online

Please share with us any interesting stories about your connection to Israel

How often do you:

Read self-help books, articles, websites, or apps?

Attend workshops or events for personal growth?

Which of the following best describes you:

Please tell us what you hope to gain from your MOMentum Year-Long Journey:

Email	Facebook
Flyer	Friend/Relative
Momentum website	Local outreach or learning center
Local synagogue	Newspaper
Ad	Other
Past Participant	Web search engine

AIPAC	Jewish Federation/JFNA General Assembly
Hadassah	JCCA
JNF	Other

Child 1	Gender 1	Date of Birth
Child 2	Gender 2	Date of Birth 2
Child 3	Gender 3	Date of Birth 3
Child 4	Gender 4	Date of Birth 4
Child 5	Gender 5	Date of Birth 5

Welcome to the Unity - Mothers of Lone Soldiers Trip.

Please complete the information below.

Your Lone Soldier

Employment Info

General Information