VOLUNTEER

Name*

First Last

Email*

Phone*

Age*

Birthdate*

[symple_box color="red" fade_in="true" float="center" text_align="left" width=""] At this time, we are only accepting people from the NY/NJ area or the LA area.[/symple_box]

Your City*

Gender*

Male
Female

Jewish Nationality*

Passport #*

Country of Citizenship*

USA
Canada

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What extracurricular activities, hobbies and organizations are you involved in? Please describe your participation in them:*

Parents

Parent's Marital Status*

Was your father born Jewish?*

Yes
No

Please Explain Father's Situation*

Was your mother *born* Jewish?*

Yes
No

Please Explain Mother's Situation*

Mother

Mother's Name (First)*

Mother's Name (Last)*

Mother's Email*

Mother's Phone*

Mother's Occupation*

Father

Father's Name (first)*

Father's Name (last)*

Father's Email*

Father's Phone*

Father's Occupation*

Were ALL your grandparents born Jewish?*

Yes
No

Please Explain Grandparent Situation*

Education / Work

Are you in school and/or working?*

School
Working

School Name*

School Graduation Year*

School Degree*

School Focus/Major*

Employer*

Job Title*

Background

Jewish Affiliation*

Jewish Education*

Describe your Jewish education*

A turn off
Insufficient
Complete

Do you hold any leadership/professional positions in Jewish organizations?

If so, please tell us about it- which organization? position? achievements...

Have you ever been to Israel before?*

Yes
No

[symple_box color="red" fade_in="false" float="center" text_align="left" width=""] Please be very truthful about this question, as we will follow up to verify this information. Thank you.

People have not been truthful in the past and it caused them to pay a huge penalty. Your honesty is appreciated ;)[/symple_box]

Check off all the trips/learning you've done in Israel (not including Family trips, Bar Mitzvahs, weddings or travelling with friends)*

*Cool, you went on Birthright (like most people!) How did you like it? Was it what you expected? Were you disappointed in any way?*

My top 4 life priorities are:*

Application Essay*

REQUIRED - Fill this box with your story as to why you feel you want to go on our trip AND what you hope to gain from it.

I'm Most Interested In The Following Position...*

This year we're making it bigger than ever! We're looking for volunteers who want to bring their personal passions to the Gesher experience as well! Let us know which role(s) you're most interested in!

References

Reference*

Who Refered you to the program?*

[symple_box color="blue" fade_in="false" float="center" text_align="left" width=""] Special Requirements[/symple_box]

Do you have any accessibility requirements or physical limitations or restrictions?*

Yes
No

please elaborate accessibility resctrictions

Do you have special dietary requirements?*

Yes
No

Please elaborate dietary needs

Are you or have you received medical treatment or psychological counseling?*

Yes
No

please elaborate treatments

Are you currently taking any medication?*

Yes
No

please elaborate medication

Have you ever been hospitalized?*

Yes
No

please elaborate hospitalization

Last part! (Please answer accurately)

Are you a practicing Jew?*

How involved and excited are you to be part of your Jewish community?*

Ready to help make a difference? You’ve come to the right place! Apply for our summer trip & reap the benefits of giving back!