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My name
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My name in Hebrew
כפי שרשום בדרכון
My surname in Hebrew
כפי שרשום בדרכון
Nickname
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My Email
I.D.
I.D.
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Birthdate
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Vanuatu
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בחירה
Community
Postal code
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Israel
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Afghanistan
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Albania
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Argentina
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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
Postal code
City in Israel ID
HIDDEN FIELDS
Partnership Form ID
Partnership Form name
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PartnershipID
ProjectID
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Additional details
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Facebook
Facebook
Profession
Profession
My role in a partnership
My role in a partnership
Organization
Organization
My role in the organization
My role in the organization
Additional comments about myself
Additional comments about myself
Summary of my professional CV over the past 5 years
Summary of my professional CV over the past 5 years
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Parents’ details
Parents’ marital status:
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Parent 1’s details
Parent 1's name
Parent 1’s mobile no.
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Parent 2’s details
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Parents’ details
Parents’ marital status:
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Parent 1’s details
Parent 1's name
Parent 1’s mobile no.
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Parent 2’s details
Parent 2’s name
Parent 2’s mobile no.
Parent 2’s email
Parent 2’s occupation
If you have any comment/clarification about the parental situation, please clarify (separated, divorced, single parent, live in different addresses etc.)
Emergency contact person
Emergency contact person’s full name
Emergency contact person’s mobile phone
Emergency contact person’s email
Emergency contact person’s kinship
Emergency contact person
Emergency contact person’s full name
Emergency contact person’s mobile phone
Emergency contact person’s email
Emergency contact person’s kinship
Guardian
Guardian’s full name
Guardian’s mobile no
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Guardian’s relationship
Guardian
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Guardian’s mobile no
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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
Surname as appears in the passport
Date of birth
DD/MM/YYYY
Passport No.
Passport issue date
Expiration date
Nationality of passport
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
Date of birth
DD/MM/YYYY
Passport No.
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.
Visa / ESTA / eTA expiration date
I have no visa / I have no valid visa
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Education details
Type (please choose value)
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Student
Teacher
Pupil
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Teacher
Name of School
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Class
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1
2
3
4
5
6
7
8
9
10
11
12
Study Subjects
Pupil
Name of School
School Address
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2
3
4
5
6
7
8
9
10
11
12
Name of Educator Teacher
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Student
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Studying Degree
Year of Schooling
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Details
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):
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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):
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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
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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
Allergies
Some other things that are important to me relating to food
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):
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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):
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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):
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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...
I will be happy to host up to...
Details we should know for a pleasant stay
Pets in the house:
Yes
No
Details about pets in the house:
Pets in the house:
Yes
No
Details about pets in the house:
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 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
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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
Do you have any standing prescriptions
Yes
No
Details of standing prescriptions
Do you have any physical limitations
Yes
No
Details of physical limitations
Do you have any allergies or sensitivities
Food
Animals
Medications
Other
None
I have sensitivity and allergy to...
Did you have any sessions with a psychologist/therapist in the past two years?
Yes
No
Details of sessions with a psychologist/therapist
Were you hospitalization during the past two years
Yes
No
Details of hospitalization
Health related comments
Do you have any medical issues?
Yes
No
Details of medical issues
Do you have any standing prescriptions
Yes
No
Details of standing prescriptions
Do you have any physical limitations
Yes
No
Details of physical restrictions
Do you have any allergies or sensitivities
Food
Animals
Medications
Other
None
I have sensitivity and allergy to...
Did you have any sessions with a psychologist/therapist in the past two years?
Yes
No
Details of sessions with a psychologist/therapist
Were you hospitalization during the past two years
Yes
No
Details of hospitalization
Health related comments
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...
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Additional details about you
My hobbies
Details about my hobbies
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
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
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
Why are you suitable to be a part of the program
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My sweatshirt size (please choose value):
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שאלה 1
שאלה 2
שאלה 3
שאלה 4
שאלה 5
שאלה 6
שאלה 7
שאלה 8
שאלה 9
שאלה 10
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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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