Please enable JavaScript in your browser to complete this form.Synagogue Name (As you would like it to appear on title of your assessment) *Synagogue Address *Address Line 1City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeYour Synagogue's average weekly in person attendanceYour Synagogue's average weekly online attendance (if applicable)Your Name as our Contact Person for Communication *FirstLastYour title/role *Email *All future communications will be sent to this email address. Please be sure to check your spam and junk boxes for our notifications. PhoneDate you are wanting to launch the assessment: Customizing Your AssessmentPlease select for your Average Weekly Attendance Range: *Under 150 people150-499 people500-749 people750-999 people1000+ peopleReason for running this assessment *Strategic PlanningClergy SearchFinancial CampaignVitality CheckWhat Clergy language should we use? *Current RabbiCurrent ClergyFormer Rabbi (use if former Rabbi left less than 4-6 months ago and the interim has been there for less than 6 months)Former Clergy (use if former Clergy left less than 4-6 months ago and the interim has been there for less than 6 months)Interim Rabbi (use if the interim has been there for more than 6 months)Other (Please provide the clergy language you would like in the “other notes” section)Would you like to add additional subreports to your order? Please note there is a cost per subreport. Reports by Age – $120.00Reports by Tenure – $120.00Reports by Frequency of Attendance – $120.00Reports by Financial Amount Given – $120.00Reports by Prayer Service Time which need to be included in the supplemental questions – $120.00Your 5 supplemental questions (Optional unless you need to add questions for the crosstabs ordered above):Supplemental questions can be drafted by church leadership to help answer questions about synagogue needs. Please avoid questions regarding decisions on who will be your next Rabbi, decisions around who you are and are not willing to hire in leadership roles, and other important specific outcomes that need further discussion.Other notes or anything else you would like us to know before we build your order?Terms: *I understand and accept the terms of this agreement for running the instrument. I understand that these instrument. I understand that refunds are not available once the assessment has been built.Payment Options How will you be paying today?* *Pay with PaypalPay by credit cardA third party (such as a regional association or consultant) pays for this service*Unless previously arranged, your assessment will be ready once payment is received. You have asked us to bill a third party for your assessment please add below the name of Organization the invoice is being sent to and the email address of where the invoice should be sent. Please note without this information we cannot build your assessment. Total $0.00Credit Card via Stripe *CardName on CardMessageTo Submit Order!
