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Name:
   
 
 
 
What religious affiliation did your family have growing up?
 
Unaffiliated
 
Reform
 
Conservative
 
Reconstructionist
 
Conservadox
 
Traditional
 
Modern Orthodox
 
Orthodox
 
Other
 
 
 
 
Did you attend any public high school before Machon Maayan?
 
Yes
 
No
 
Other
 
 
 
 
If Yes, you attended Public School, what is the name of it and what city?
   
 
 
 
After Machon Maayan did you continue with a different Jewish study program?
 
Yes
 
No
 
No, but I would have if I had the opportunity.
 
 
 
If yes you continued Torah study after Machon Maayan, which program, and for how long?
   
 
 
 
Which university/college did you attend after Machon Maayan? Name of University: City: If you attended Stern, were you in the Mechina program? Years attended:
   
 
 
 
Which city are you living in now?
   
 
 
 
Are you living in a Jewish community with an eruv?
 
Yes
 
No
 
 
 
Are you currently involved in Jewish studies?
 
Yes
 
No
 
 
 
If you are currently involved in Torah studies, how often?
 
Daily
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
Other
 
 
 
 
Do you currently observe Shabbat?
 
Yes
 
No
 
 
 
If you Yes, you currently observe Shabbat, which best describes how?
 
I am strictly Shomer Shabbat including all of the Halachot I know.
 
I am Shomer Shabbat except the use of electricity.
 
I am Shomer Shabbat except the use of my phone.
 
Other
 
 
 
 
Do you currently eat Kosher?
 
Yes
 
No
 
 
 
If Yes you eat Kosher, to what degree?
 
I eat only strictly supervised Kosher food at home and out of the house.
 
I have a Kosher kitchen, but eat not Kosher out of the house.
 
I eat only Kosher meat and chicken.
 
Other
 
 
 
 
Have you made changes in the type of clothing you wear since you went to Machon Maayan?
 
Yes
 
No
 
Other
 
 
 
 
If Yes you changed the way you dress how would you best categorize it?
 
I wear only clothing defined as modest or "Tznuis" by Halachic standards.
 
I am more careful but I wear pants in public.
 
I am not very strict, but try to dress more modestly than before I went to Machon Maayan.
 
Other
 
 
 
 
If you are married, do you cover your hair?
 
Yes
 
No
 
Other
 
 
 
 
What is your marital status?
 
Single
 
Married
 
Engaged
 
Divorced
 
 
 
If married, is your husband?
 
Less Religious than You
 
More Religious than You
 
The Same Religiosity as You
 
Other
 
 
 
 
If married, did your husband study in Yeshiva post high school?
 
Yes
 
No
 
Other
 
 
 
 
If your husband studied in Yeshiva, which one and for how long? Which years?
   
 
 
 
How would you define your current religious affiliation?
 
Reform
 
Conservative
 
Traditional
 
Modern Orthodox
 
Central Orthodox
 
Religious Zionist
 
Yeshivaish
 
Other
 
 
 
 
Do you currently belong to a synagogue? If yes, which one?
   
 
 
 
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