Which week are you applying to (can select multiple if undecided): *
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First Name *
Your answer
Last Name *
Your answer
Date of Birth *
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DD
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Email address - We will contact you shortly *
Your answer
WhatsApp Number: *
Your answer
Address (if you are on a program in Israel, please list your address from your country of origin) *
Your answer
Country of Origin *
Your answer
Is one or both of your parents Jewish? *
Are you currently (or going to be) on an organized trip in Israel? If yes, which one? *
Your answer
If you are on a current program in Israel, please provide the name and contact information (email & phone number) for your Madricha/Coordinator in case of emergency. If this doesn't apply to you, please write "N/A". *
Your answer
How did you hear about our program? *
You will be requested to take a travel Insurance Policy *
If you have food allergies or any other important health issue, please let us know
Your answer
Your program is subsidized and will only cost you $250. Once you are notified of your acceptance on the program you will be invited to pre-pay. A Paypal link will be sent to your mail. *
What is your level of Hebrew? (That's in case you are invited to local family to one of the shabbat meals).
Your answer
This program will be run in accordance with the most current Ministry of Health guidelines. *
Do you have any other friends who might be interested in joining? Please add their name, phone and email here, and we will be happy to invite them along!
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