Community of Belonging Assessment & Workbook Request Form

Welcome!

We are glad that you are interested in the Community of Belonging Assessment & Workbook.

In order to download the Community Assessment, please fill out the form below.

To Download the PDF:

Upon completion of the form, you will see a confirmation page with links to the Assessment & Workbook in PDF format. You can save the PDF to your computer.

We recommend that you complete this form on a desktop or laptop computer.

Your information

First Name

Last Name

Your Role in your Congregation/Community

Congregation Information

Are you a member/employee of a URJ congregation?

YesNo

Congregation

Congregation ID

Community name (if not part of a URJ Congregation)

Congregation/Community City

Congregation/Community State/Province

Zip/Postal Code

If other, please explain:

Would you be interested in participating in a Diversity, Equity, and Inclusion (DEI) online training that supports your learning and implementation of the Assessment?

YesNoNot me, but someone in my community would

Check here if you are interested in receiving more Diversity, Equity, and Inclusion (DEI) tools and resources as they become available:

Yes, I am interested

Do you have any additional questions or comments at this time?:

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