First Name
Gender
Date of Birth
School
Stanford University Choose One Other University of California, Berkeley UCLA USC California Institute of Technology UCSD University of California, Davis UCSB University of California, Irvine Academy of Art University San Diego State University San Francisco State University California State University, Northridge California State University, Long Beach California Polytechnic State University, San Luis Obispo San Jose State University California State University, Chico University of California, Riverside California State University, Sacramento University of California, Santa Cruz California State Polytechnic University, Pomona California State University, Fullerton University of Judaism California State University, Fresno California Institute of the Arts William Howard Taft University California State University, Los Angeles Pepperdine University Monterey Institute of International Studies Fielding Graduate Institute Santa Clara University University of San Francisco Chapman University Humboldt State Uni Biola University Sonoma State University Loma Linda University California State University, San Bernardino California State University, Dominguez Hills Loyola Marymount University California State University, East Bay Charles R. Drew University of Medicine and Science Southwestern University School of Law Azusa Pacific University Mills College Golden Gate University La Sierra University California State University, San Marcos University of San Diego Fresno Pacific University California State University, Stanislaus
Home Address
School Address
Cell Phone
Dorm/Apt Phone
E-Mail Address
Father’s Name
Mother’s Name
Parent’s Phone Number
Parent’s Marital Status
Is your Mother born Jewish?
Is your Father born Jewish?
Choose 0ne Yes No
List the names, ages of your siblings and whether any of them are in college right now : (John Doe in/not in college).
1.
2.
3.
4.
Current year in school
Major
Which high school did you attend?
Please list post-secondary schools you have attended, other than the one presently attending. Entries should be completed in chronological order, beginning with the most recent.
List any academic honors or other distinctions that you have received since the ninth grade.
Have you visited the Trips destination in the past?
What have you done over the past two summers?
What are your plans for next year?
List the extracurricular activities you have been involved in (including high school) and describe your participation.
Please list your past jobs (entries in chronological order, beginning with the most recent.)
What role do you see Judaism “playing” throughout your life and
why are you interested in joining this trip?
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Thank you for completing this application form and for your interest in joining the JAM Israel Trip.
