Use the form below to apply for the Shalom Hartman Institute's Hevruta Gap Year Program.

All applicants must be in their final year of high school. For us to review your application, you should submit both parts of the form. Once you submit part 1, you will be redirected to part 2 automatically. All relevant applicants will be invited for a personal interview.

Application for fall 2022-2023 has been extended and we are accepting applications until March 1, 2022. Interviews will be held during the last two weeks of February and the first week of March.

If you are having difficulty submitting this form, or have any questions regarding the application process please contact us at

office.hevruta@shi.org.il

לטופס ההרשמה לתוכנית לישראלים לחצו כאן

Personal Information

First Name

Last Name

Please specify your birthdate (MM/DD/YYYY):

Gender Identity:

Pronouns

Gender Identity:

Pronouns:

Personal Email Address:

Home Phone Number:

Mobile Phone Number:

Mailing Address

Country

City

State

Provinces

State/Province

Postal Code

Geographic Region

Please attach a recent photo of yourself facing the camera:

Family Information

Please provide information about your parents or legal guardians.

Parent or Guardian #1

First Name:

Last Name:

Relationship to Applicant:

Mother

Father

Other

Please Elaborate:

Email Address:

Mobile Phone Number:

Occupation:

We require information about both parents or legal guardians.

Click here to provide details on a second parent or legal guardian.I do not have a second parent or legal guardian.

Parent or Guardian #2

First Name:

Last Name:

Relationship to Applicant:

Mother

Father

Other

Please Elaborate:

Email Address:

Mobile Phone Number:

Occupation:

Educational Information

Please select your school from the list below.

If you are home schooled, please select the "Homeschooled" option.
If you do not see your school on this list, please select the option "I don't see my school on this list," and check the box below.

High School Name:

School Account ID

I don't see my school on the list.

School Information

Name of School:

Country

Mailing Address

City

State

Provinces

State/Province

Postal Code

Geographic Region

Hebrew and Religious Education

Please rate your Hebrew skills:

If you're not currently enrolled in a Jewish day school, have you attended Jewish day school in the past?

I am currently enrolled in a Jewish day school.I have attended Jewish day school in the past.I have not attended Jewish day school in the past.

Previous Jewish Day School

Name of School:

Grades Attended:

Do you currently or have you previously attended Jewish Sunday school?

YesNo

Current or Previous Sunday School

Name of School/Synagogue:

Grades Attended:

Have you ever attended a Jewish Summer Camp?

YesNo

Current or Previous Jewish Summer Camp

Name of Camp:

Grades Attended:

Does your family belong to a synagogue or congregation?

YesNo

Synagogue or Congregation Info:

Name of Synagogue:

Country

Mailing Address

City

State

Provinces

State/Province

Postal Code

Geographic Region

Please describe your involvement with the synagogue:

Extracurricular Activities

Please describe any relevant leadership positions or training experiences in which you participated in high school. (100 word maximum)

Have you participated in an ongoing volunteer experience? Please share the nature of the work and its impact on your life. (100-word maximum)

Have you participated in organized Jewish youth activities such as a Jewish youth movement, Jewish travel program, or other Jewish summer experiences? If so, please name and describe the program(s). (100-word maximum)

Please share what you like doing in your spare time. This could be hobbies, interests and other. (100-word maximum)

Thank you for completing Part I of the Hevruta application.

You will receive an email with a link to Part II, in which you will be asked to answer a few more questions as well as upload a short video about your life.

You will also be asked to pay a $100 non-refundable application fee.

Salesforce IDs for participation records

Program ID - Insert Program ID here as DEFAULT VALUE

Seminar ID - Insert Seminar ID here as DEFAULT VALUE

	None	Some	Average	Very Good	Fluent
Proficiency in READING
Proficiency in WRITING
Proficiency in SPEAKING

Reform	Conservative	Orthodox
Reconstructionist	Renewal	Traditional
Secular	Non-denominational	Just Jewish
Other