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P2G Solidarity mission to the WG
General info on form rich text
Personal details
My name
30 characters left.
My surname
30 characters left.
My name in Hebrew
כפי שרשום בדרכון
My surname in Hebrew
כפי שרשום בדרכון
Nickname
30 characters left.
Nickname
30 characters left.
Mobile No.
10 characters left.
My Email
30 characters left.
I.D.
9 characters left.
I.D.
9 characters left.
Birthdate
DD/MM/YYYY
Birthdate
DD/MM/YYYY
Gender
Please select...
Male
Female
Other
Gender
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Male
Female
Other
Additional phone
10 characters left.
Additional phone
10 characters left.
Address
Street and House No.
50 characters left.
City
20 characters left.
Country
Please select...
Israel
USA
Afghanistan
Åland Islands
Albania
Algeria
Amer.Virgin Is.
Andorra
Angola
Anguilla
Antarctica
Antigua/Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herz.
Botswana
Bouvet Island
Brazil
Brit.Ind.Oc.Ter
Brit.Virgin Is.
Brunei Dar-es-S
Bulgaria
Burkina-Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central Afr.Rep
Chad
Chile
China
Christmas Islnd
Coconut Islands
Colombia
COLORADO
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Rep.
Dutch Antilles
East Timor
Ecuador
Egypt
El Salvador
Equatorial Gui.
Eritrea
Estonia
Ethiopia
Falkland Islnds
Faroe Islands
Fiji
Finland
France
Frenc.Polynesia
French Guayana
French S.Territ
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard/McDon.Isl
Holand
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islnds
Martinique
Mauretania
Mauritius
Mayotte
Mexico
Micronesia
Minor Outl.Ins.
Moldavia
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
N.Mariana Islnd
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue Islands
Norfolk Island
North Korea
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua Nw Guinea
Paraguay
Peru
Philippines
Pitcairn Islnds
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Ruanda
Russian Fed.
S. Sandwich Ins
S.Tome,Principe
Saint Barthelemy
Saint Martin
Samoa, American
San Marino
Saudi Arabia
Scotland
Senegal
Serbia
Serbia Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
St Kitts&Nevis
St. Helena
St. Lucia
St. Vincent
St.Pier,Miquel.
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikstan
Tanzania
Thailand
Togo
Tokelau Islands
Tonga
Trinidad,Tobago
Tunisia
Turkey
Turkmenistan
Turksh Caicosin
Tuvalu
Uganda
Ukraine
United Kingdom
Uruguay
Utd.Arab Emir.
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis,Futuna
West Sahara
Western Samoa
Yemen
Yugoslavia
Zambia
Zimbabwe
בחירה
Community
20 characters left.
Postal code
6 characters left.
Address
Street and House No.
20 characters left.
City
20 characters left.
Country
Please select...
Israel
USA
Afghanistan
Åland Islands
Albania
Algeria
Amer.Virgin Is.
Andorra
Angola
Anguilla
Antarctica
Antigua/Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herz.
Botswana
Bouvet Island
Brazil
Brit.Ind.Oc.Ter
Brit.Virgin Is.
Brunei Dar-es-S
Bulgaria
Burkina-Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central Afr.Rep
Chad
Chile
China
Christmas Islnd
Coconut Islands
Colombia
COLORADO
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Rep.
Dutch Antilles
East Timor
Ecuador
Egypt
El Salvador
Equatorial Gui.
Eritrea
Estonia
Ethiopia
Falkland Islnds
Faroe Islands
Fiji
Finland
France
Frenc.Polynesia
French Guayana
French S.Territ
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard/McDon.Isl
Holand
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islnds
Martinique
Mauretania
Mauritius
Mayotte
Mexico
Micronesia
Minor Outl.Ins.
Moldavia
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
N.Mariana Islnd
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue Islands
Norfolk Island
North Korea
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua Nw Guinea
Paraguay
Peru
Philippines
Pitcairn Islnds
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Ruanda
Russian Fed.
S. Sandwich Ins
S.Tome,Principe
Saint Barthelemy
Saint Martin
Samoa, American
San Marino
Saudi Arabia
Scotland
Senegal
Serbia
Serbia Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
St Kitts&Nevis
St. Helena
St. Lucia
St. Vincent
St.Pier,Miquel.
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikstan
Tanzania
Thailand
Togo
Tokelau Islands
Tonga
Trinidad,Tobago
Tunisia
Turkey
Turkmenistan
Turksh Caicosin
Tuvalu
Uganda
Ukraine
United Kingdom
Uruguay
Utd.Arab Emir.
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis,Futuna
West Sahara
Western Samoa
Yemen
Yugoslavia
Zambia
Zimbabwe
בחירה
Community
20 characters left.
Postal code
6 characters left.
City in Israel ID
HIDDEN FIELDS
Partnership Form ID
2 characters left.
Partnership Form name
18 characters left.
Ending message
250 characters left.
PartnershipID
2 characters left.
ProjectID
2 characters left.
End Date
General info on form not in use
Subtitle
100 characters left.
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FA nick name
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FA teudat zehut
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FA Gender
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FA Mailing Street
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FA Mailing Zip
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FA Address
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Additional details
Other things we would like to know about you
Facebook
100 characters left.
Facebook
100 characters left.
Profession
50 characters left.
Profession
50 characters left.
My role in a partnership
50 characters left.
My role in a partnership
50 characters left.
Organization
50 characters left.
Organization
50 characters left.
My role in the organization
50 characters left.
My role in the organization
50 characters left.
Additional comments about myself
200 characters left.
Additional comments about myself
500 characters left.
Summary of my professional CV over the past 5 years
1000 characters left.
Summary of my professional CV over the past 5 years
1000 characters left.
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FA Facebook
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FA Proffession
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FA position in partnership
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FA contact notes
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FA contact bio
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FA contact organization
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FA contact organization job
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FA contact additional info page
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Parents’ details
Parents’ marital status:
Please select...
Married
Divorced
Separated
Single parent
Widow(er)
Other
Parent 1’s details
Parent 1's name
20 characters left.
Parent 1’s mobile no.
10 characters left.
Parent 1’s email
50 characters left.
Parent 1’s occupation
30 characters left.
Parent 2’s details
Parent 2’s name
20 characters left.
Parent 2’s mobile no.
10 characters left.
Parent 2’s email
50 characters left.
Parent 2’s occupation
30 characters left.
Parents’ details
Parents’ marital status:
Please select...
Married
Divorced
Separated
Widow(er)
Single parent
Other
Parent 1’s details
Parent 1's name
20 characters left.
Parent 1’s mobile no.
10 characters left.
Parent 1’s email
50 characters left.
Parent 1’s occupation
30 characters left.
Parent 2’s details
Parent 2’s name
20 characters left.
Parent 2’s mobile no.
10 characters left.
Parent 2’s email
50 characters left.
Parent 2’s occupation
30 characters left.
If you have any comment/clarification about the parental situation, please clarify (separated, divorced, single parent, live in different addresses etc.)
500 characters left.
Emergency contact person
Emergency contact person’s full name
80 characters left.
Emergency contact person’s mobile phone
10 characters left.
Emergency contact person’s email
50 characters left.
Emergency contact person’s kinship
20 characters left.
Emergency contact person
Emergency contact person’s full name
80 characters left.
Emergency contact person’s mobile phone
10 characters left.
Emergency contact person’s email
50 characters left.
Emergency contact person’s kinship
20 characters left.
Guardian
Guardian’s full name
80 characters left.
Guardian’s mobile no
10 characters left.
Guardian’s email
50 characters left.
Guardian’s relationship
20 characters left.
Guardian
Guardian’s full name
80 characters left.
Guardian’s mobile no
10 characters left.
Guardian’s email
50 characters left.
Guardian’s relationship
20 characters left.
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FA Parental information
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FA Parental / guardian page
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FA Parent2
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FA guardian
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FA emergency contact
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Uploading photocopy of passport
Photograph your passport clearly with no light reflections (the page with the photo) and wait for the information to be updated in the various fields. If several seconds passed and the information has not been uploaded - simply type (it is important to carefully check that you properly type the data).
If you dont have a passport or if your passport expired please tick the designated place.
Photocopy of passport
First name as appears in the passport
20 characters left.
Surname as appears in the passport
20 characters left.
Date of birth
DD/MM/YYYY
Passport No.
20 characters left.
Passport issue date
Expiration date
Nationality of passport
20 characters left.
אין לי דרכון זר בתוקף
I have no passport / passport expired
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FA Darkon Zar Section
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Uploading photocopy of Israeli passport
Photograph your passport clearly with no light reflections (the page with the photo) and wait for the information to be updated in the various fields. If several seconds passed and the information has not been uploaded - simply type (it is important to carefully check that you properly type the data)
If you dont have an Israeli passport or if your passport expired please tick the designated place.
Photocopy of Israeli passport
First name as appears in the passport
Surname as appears in the passport
20 characters left.
Date of birth
10 characters left.
DD/MM/YYYY
Passport No.
20 characters left.
Israeli Passport can be numbers only
Passport issue date
Expiration date
I have no Israeli passport / passport expired
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FA Darkon Israeli Section
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Visa / ESTA / eTA
Photograph the visa or other residence permit and attach the file. If you have no visa or other residence permit, tick the designated place.
Photocopy of visa
Visa / ESTA / eTA No.
20 characters left.
Visa / ESTA / eTA expiration date
I have no visa / I have no valid visa
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FA Visa Section
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Education details
Type (please choose value)
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Student
Teacher
Pupil
Other
Teacher
Name of School
30 characters left.
Role in School
30 characters left.
Class
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1
2
3
4
5
6
7
8
9
10
11
12
Study Subjects
30 characters left.
Pupil
Name of School
30 characters left.
School Address
30 characters left.
Class
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1
2
3
4
5
6
7
8
9
10
11
12
Name of Educator Teacher
80 characters left.
Major of Study
50 characters left.
Student
Educational institution Name
50 characters left.
Main field of study/ Major
50 characters left.
Studying Degree
15 characters left.
Year of Schooling
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1st
2nd
3rd
4th
Other
Details
90 characters left.
Level of Hebrew (please choose value)
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fluent in speech only
fluent in speech, reading and writing
mother tongue
no fluency
fluent in reading only
fluent in writing only
Level of Hebrew (please choose value)
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fluent in speech only
fluent in speech, reading and writing
mother tongue
no fluency
fluent in reading only
fluent in writing only
Level of English (please choose value):
Please select...
fluent in speech only
fluent in speech, reading and writing
mother tongue
no fluency
fluent in reading only
fluent in writing only
Level of English (please choose value):
Please select...
fluent in speech only
fluent in speech, reading and writing
mother tongue
no fluency
fluent in reading only
fluent in writing only
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FA English Level
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FA Hebrew Level
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FA Schooling Section
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FA Schooling Page
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Affiliation, Eating Habits, Kashrut and Hospitality
It is important for us to provide you will all your day-to-day needs, including kashrut, eating, and hospitality habits.
Affiliation (please choose value):
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secular
traditional
religious
orthodox
reform
conservative
other
Affiliation (please choose value):
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secular
traditional
religious
orthodox
reform
conservative
other
I tend to define myself as:
vegan
vegetarian
no-gluten
no-milk
ordinary
I tend to define myself as:
vegan
vegetarian
no-gluten
no-milk
ordinary
kashrut:
Yes
No
Mehadrin
other
kashrut:
Yes
No
Mehadrin
other
Shabbat Observant
Yes
No
Travel on Shabbat:
Yes
No
Meat must be kosher
Yes
No
Separation of dishes for meat and dairy:
Yes
No
Food must be ready before Shabbat
Yes
No
Meat and dairy separation:
Yes
No
Chalav Yisrael
Yes
No
Kosher food even if the restaurant serves non-kosher food:
Yes
No
I don’t eat pork and sea food:
Yes
No
I will eat kosher meat even if slaughter in non-kosher:
Yes
No
I eat dairy/veterinarian food also in establishments without kashrut certificate:
Yes
No
Some other things that are important to me relating to food
999 characters left.
Allergies
Some other things that are important to me relating to food
999 characters left.
Allergies
Are you interested in hosting people arriving from overseas in one of the partnership’s projects?
Yes
No
Are you interested in hosting people arriving from overseas in one of the partnership’s projects?
Yes
No
Scope of hosting ( please choose value):
Please select...
meals only
accommodation only
full hosting
Scope of hosting ( please choose value):
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meals only
accommodation only
full hosting
Range of ages for hosting (please choose value):
Please select...
junior high students - 12-14 years old
high school students - 14-18 years old
students - 18-24 years old
adults - 25+
all options are possible
Range of ages for hosting (please choose value):
Please select...
junior high students - 12-14 years old
high school students - 14-18 years old
students - 18-24 years old
adults - 25+
all options are possible
I will be happy to host up to...
50 characters left.
I will be happy to host up to...
50 characters left.
Details we should know for a pleasant stay
999 characters left.
Pets in the house:
Yes
No
Details about pets in the house:
50 characters left.
Pets in the house:
Yes
No
Details about pets in the house:
50 characters left.
Will you be willing to be hosted by a family with pets?
Yes
No
Tick no if you have sensitivity or fear from animals that does not allow you to stay in the same house with a pet (normally dogs and cats)
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FA food Section
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FA Affiliation
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FA eating habits
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FA Keep Kosher
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FA Keep Shabbat
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FA Drive car on shabbat
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FA Meat needs to be kosher
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FA Kosher - separate dishes
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FA Kosher - cook food before shabbat
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FA Kosher - not mix milk and meat
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FA Kosher - milk chalav yisrael
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FA Kosher food in not kosher
restaurant
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FA Kosher food in not kosher dairy / vegan
restaurant
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FA Kosher not eat pork and seafood
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FA Kosher meat no shchita
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FA want to host
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Medical questionnaire for insurance purposes for people going on delegations
As we are responsible to insure you and maintain your health during the delegation, we are obligated to ask the following questions and are aware of any inconvenience that may be caused. Thank you for your cooperation.
Do you have any medical issues?
Yes
No
Details of medical issues
250 characters left.
Do you have any standing prescriptions
Yes
No
Details of standing prescriptions
250 characters left.
Do you have any physical limitations
Yes
No
Details of physical limitations
250 characters left.
Do you have any allergies or sensitivities
Food
Animals
Medications
Other
None
I have sensitivity and allergy to...
50 characters left.
Did you have any sessions with a psychologist/therapist in the past two years?
Yes
No
Details of sessions with a psychologist/therapist
500 characters left.
Were you hospitalization during the past two years
Yes
No
Details of hospitalization
500 characters left.
Health related comments
500 characters left.
Do you have any medical issues?
Yes
No
Details of medical issues
250 characters left.
Do you have any standing prescriptions
Yes
No
Details of standing prescriptions
250 characters left.
Do you have any physical limitations
Yes
No
Details of physical restrictions
1000 characters left.
Do you have any allergies or sensitivities
Food
Animals
Medications
Other
None
I have sensitivity and allergy to...
50 characters left.
Did you have any sessions with a psychologist/therapist in the past two years?
Yes
No
Details of sessions with a psychologist/therapist
500 characters left.
Were you hospitalization during the past two years
Yes
No
Details of hospitalization
500 characters left.
Health related comments
500 characters left.
Do you have any allergies or sensitivities
Food
Animals
Medications
Other
None
Do you have any allergies or sensitivities
Food
Animals
Medications
Other
None
I have sensitivity and allergy to...
50 characters left.
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FA medical info Section
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FA Allergy Details
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FA Health Details Page
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Additional details about you
My hobbies
250 characters left.
Details about my hobbies
1000 characters left.
First aid certificate
Yes
No
Have you done army service / national service?
Yes
No
Do you play a mucical instrument?
Yes
No
Do you swim?
Yes
No
Have you lived Abroad?
Yes
No
Have you visited Israel in the past?
Yes
No
Do you have any connection to a youth movement?
Yes
No
Used to
Details about youth movements
100 characters left.
Are you volunteering in the community
Of course
Not part of my life
I used to be
Have you done any tutoring in the past?
No
Yes, with certificates
Yes, without certificate
Upload Certificate
Do you have experience tutoring?
Yes
No
Details about your tutoring experience
2000 characters left.
Do you know anyone who participated in the Agency's program?
Yes
No
Details of people I know who participated in the Agency's programs
I have participated in JAFI programs in the past
Yes
No
Past JAFI program details
1000 characters left.
Why are you suitable to be a part of the program
250 characters left.
My shirt size (please choose value):
Please select...
XS
S
M
L
XL
XXL
My sweatshirt size (please choose value):
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XS
S
M
L
XL
XXL
Do you wish to pay extra for a single room?
250 characters left.
Name of Jewish Federation
250 characters left.
Date of Birth
250 characters left.
Do you have any medical issues or Physical limitations?Please Describe
250 characters left.
Do you have any allergies to food / Animals / Medications / Others / None
250 characters left.
שאלה 6
250 characters left.
שאלה 7
250 characters left.
שאלה 8
250 characters left.
שאלה 9
250 characters left.
שאלה 10
250 characters left.
show/hide hobbies section
FA hobbies Page
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FA first aid
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FA army service
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FA musical
instrument
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FA know to swim
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Uploading Documents
There are some documents it is important to attach - if you have any problem with one or more, we are here and you can contact us
Recent photo of yourself
Photocopy of I.D. card + appendix
Parents’ confirmation
Hosting family’s letter
Recommendation letter
Flight Ticket
CV
Health statement
Medical confirmation
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This is it. Now you can send it :)
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