Scholarship Application

Scholarship Application
Are you an Olami Launch Fellow?*

YesNo
Do you live in the USA?*

YesNo
In this form we will ask you to upload the acceptance letter

to your yeshiva / seminary.
First Name*
Last Name*
Email*
US Phone Number*
Please enter a valid phone number.
Non-US Phone Number*

Country CodeArea CodePhone Number
US Address*

Street Address

Street Address Line 2

CityState

Zip Code
Non-US Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Gender*
Your birthday*

MonthDayYear
Date
Would you like to upload a picture OR take one now?*

UploadTake It Now
Upload a picture of your choice*

Cancelof
Take Photo*
What high school do you currently attend?*
Did you attend the same school for the past four years?*

YesNo
Please list the name (names) of the school(s) you attended in the past three years?
Current Grade*
What are your interests: extra-curricular, leadership, hobbies etc. ?*
What were/are the biggest challenge(s) you faced when considering attending a gap year program in Israel?*
How did you overcome these challenges?*
Which organization(s) have you been involved with?*

NCSY/JSUCteenUSYOorahMJCBatyaBBYOther(s)
How long have you been involved with this organization(s)?*
What region of NCSY / JSU?*

ATLANTIC SEABOARDCANADACENTRAL EASTGREATER ATLANTAMIDWESTNEW ENGLANDNEW JERSEYNEW YORKSOUTHERNSOUTHWESTUPSTATE NEW YORKWEST COAST*I HAVE NO IDEA
Which yeshiva are you planning on attending?*

Aish GesherDerechKerem b'Yavneh (KBY)Lev AharonOhr DovidNetiv AryehShaarei Mevaseret ZionTorat ShragaYishrei Lev
Which seminary are you planning on attending?*

Aish Gesher for WomenBa’er MiriamBnot Torah (Sharfmans)Darchei BinahMachon MaayanMeorot YerushalayimMichlalahMidreshet TehillahMMY (Michlelet Mevaseret Yerushalayim)Tomer Devorah
Upload your gap year acceptance letter*

Cancelof
Olami Launch sometimes uses pictures and other media of our students in our publicity material.*

You may include my image in publicity materials
Olami Launch wants to keep up with our students by sending an annual survey for three years after your gap year to see how you are doing.*

I will fill out those surveys
Sometime during your gap year, Olami Launch will ask you to write a thank you note to our sponsors.*

I agree to do so
One last thing...Olami Launch runs a program called Continue Your Journey. As part of that program we run shabbatonim for Olami Launch students after their gap year.*

I will attend at least one shabbaton in Israel or North America in 2024 or 2025
A required parental consent form will be sent directly to your parent / guardian upon completion of this application.
Parent / Guardian #1 Name*

First NameLast Name
Parent #1 Email*
Parent #1 US Phone Number*
Please enter a valid phone number.
Parent #1 Non-US Phone Number*

Country CodeArea CodePhone Number
Parent / Guardian #2 Name

First NameLast Name
Parent #2 Email
Parent #2 US Phone Number
Please enter a valid phone number.
Parent #2 Non-US Phone Number

Country CodeArea CodePhone Number
Provide the name & email of two references like rabbis, teachers, advisors etc. that know you.

A short form will be sent to them to submit.
Reference #1 First Name*
First Name
Reference #1 Last Name*
Last Name
Reference #1 Email*
Reference #1 US Phone Number*
Please enter a valid phone number.
Reference #1 Non-US Phone Number*

Country CodeArea CodePhone Number
Reference #2 First Name*
First Name
Reference #2 Last Name*
Last Name
Reference #2 Email*
Reference #2 US Phone Number*
Please enter a valid phone number.
Reference #2 Non-US Phone Number*

Country CodeArea CodePhone Number
I confirm that all information above is accurate and true. I understand that any false information can result in the disqualification of this application.
Date

MonthDayYear
Date
Signature*

Powered by Jotform Sign Clear
Should be Empty: