Rochester ShinShinim Host Family Application
We are currently accepting applications for the Spring Session of the 2022-2023 school year. For more information about ShinShinim, visit www.jewishrochester.org/shinshinim
Prospective Host Family Last Name
Street Address Line 2
State / Province
Postal / Zip Code
Primary Phone Number
Adult 1 Name
Adult 1 Cell Phone Number(s)
Adult 1 Work Phone Number(s)
Adult 1 Email
Adult 2 Name
Adult 2 Cell Phone Number(s)
Adult 2 Work Phone Number(s)
Adult 2 Email
Do they live at home? (please write "college" if away at college)
Are there others who live in the home?
Please include all relevant information: Name, age, gender
Why are you interested in hosting a ShinShin (Young Israeli Emissary)?
Which dates are your family open to hosting? Dates are currently approximate. More specific dates will be provided before you are asked to commit. Choose all that apply:
Beginning of Sept — end of Jan
Beginning of Feb — Mid June)
Interested but can't commit without knowing more. Please contact me.
Please add any date-related info/conflicts/questions here:
What are some things you like to do together as a family?
Including meals, hobbies, outing, errands, etc. We will use this information when matching ShinShinim with their families.
What is your family's typical weekly schedule? When is dinner? Who is home for dinner?
When is bedtime?
During the week
For the adults:
For the kids:
What are your community affiliations, both Jewish and secular?
Synagogues, schools, agencies, etc.
Dietary practices- Please choose all the answers that apply. Your home is:
Definitely not kosher
Has someone with a serious food allergy
Shabbat practices- Please choose all that apply.
We are Shomer Shabbat (we are strictly observant)
We do not drive on Shabbat
We do not cook on Shabbat
We do not use cell phones, tv and other electrical devices on Shabbat
We celebrate kabbalat Shabbat and Shabbat dinners together as a family
We attend Shabbat services on a regular basis
We spend quality time together as a family
If you would like to elaborate on your Shabbat practices, please do so here:
Do you have any pets?
Does anybody in your household smoke?
Has anyone in your family lived in Israel? Please explain:
Has anyone in your family visited Israel? Please provide details:
Who, when, how many times, etc.
Does anyone in your family speak Hebrew?
Should be Empty: