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Hevruta Gap Year Application -- Part 1

Thank you for your interest in the Shalom Hartman Institute's Hevruta Gap Year Program! We are excited to get to know you. If you have any questions during your application process, please send us an email at hevrutagapyear@shalomhartman.org.

Please be advised that this form has two parts. The first will collect demographic information, as well as some short answer questions. The second part will ask for a photo, video, and contact information for your recommendation. Part 2 will also require a non-refundable $100 deposit. You must complete both parts of the form in order to be considered for the program.

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


לטופס ההרשמה לתוכנית לישראלים לחצו כאן 
Personal Information

Family Information

Please provide information about your parents or legal guardians.
Parent or Guardian #1

Parent or Guardian #2

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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. 

School Information

Hebrew and Religious Education

Please rate your Hebrew skills:
None Some Very Good Fluent

Previous Jewish Day School

Current or Previous Sunday School

Current or Previous Jewish Summer Camp

Synagogue or Congregation Info:

Hevruta Logo
Extracurricular Activities

Personal Viewpoints
Please respond to the questions below in no more then 500 words each. There are no right or wrong answers, just different perspectives.

Thank you for completing Part 1 of the Hevruta application!

You will receive an email with a link to Part 2, in which you will be asked to upload a photo, video, and provide contact information for your recommendation.

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
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