60 Haight Street, San Francisco, CA 94102 Massah Israel Application

Massah Project Application

Jews for Jesus, 60 Haight St, San Francisco, CA 94102
GENERAL INFORMATION
Date:

MonthDayYear
Date
Full Name:
Date of Birth:*
T-shirt size:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Address:
City/State/Zip:
Home phone:*
Cell phone:
Email:*
Please attach a photo:

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Please attach your written testimony, no more than 500 words:

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Massah Tier 1 will be from May 29th - June 22nd.
(NYC from May 29th-31st and Israel from June 1st - 22nd)

Massah Tier 2 Extension is an Add-On from June 22nd - July 27th
(Israel from June 22nd - 29th and India from June 29th - July 27th)
Which Tier(s) will you be attending?*

I will only be attending Massah Tier 1I will be attending both Massah Tier 1 & Tier 2
FAMILY LIFE
Marital Status:
Name of partner, if applicable:
Is your partner a believer in Jesus?

YesNo
Does your partner know of this application?

YesNo
Are they in support of it? Please explain.
My father is:

Jewish believerJewish unbelieverNot Jewish
My mother is:

Jewish believerJewish unbelieverNot Jewish
My father is:

Jewish believerJewish unbelieverNot Jewish
My mother is:

Jewish believerJewish unbelieverNot Jewish
Do your parents know of this application?

YesNo
Are they in support of it? Please explain.
FAMILIARITY WITH JEWS FOR JESUS
Do you receive any Jews for Jesus publications?

YesNo
Please list any Jews for Jesus events that you have attended/participated in:
What?/Where?
Do you know any of our staff workers personally?

YesNo
Please list individuals you know best:
Have you ever participated in any missions projects?

YesNo
Please explain when, where and how you were involved:
SELF INVENTORY

boldcautiouscreativecriticaleasily offendedenergeticfollowerfriendlygenerousimpatientinconsiderateintellectualintolerantirritableleaderlistenermethodicalorganizedperfectionistself-motivatedsensitivedepressedtenseworried
Do you speak any foreign language(s)?

YesNo
If yes, please list and describe your level of proficiency:
Do you play an instrument?

YesNo
If yes, please list and describe your level of proficiency:
Please list any sports, hobbies, or spare-time activities you participate in regularly:
EDUCATION AND WORK EXPERIENCE
Highest level of formal education:
Major/Degree, if any:
Are you currently employed?

YesNo
If yes, where and how long:
If you are not currently employed what dates were you last employed and where:
MY LIFE AS A CHRISTIAN
When did you become a believer in Jesus?
Do you attend a church/congregation on a regular basis?

YesNo
If not, please explain:
The congregation I attend is:
Address (Street, City, State, Zip):
Phone:
Email:
Leader's name:
Are you a member?

YesNo
Have you been baptized?

YesNo
Would you have difficulty serving together with Christians of other denominations?

YesNo
Please review our doctrinal statement

Click here to view
Are you in agreement with our doctrinal statement?

YesNo
If no, please describe any disagreement with what's written or anything you think is missing:

MINISTRY SKILLS - Please select the option that best describes your level of experience with each area of ministry.

	No skills-lack of experience or training	Limited skill-can do if necessary, but w/ difficulty	Moderate Experience-have had some training, but not proficient	Proficient-trained or experienced and able to assume major responsibility
Literature Distribution
Sharing Your Testimony
Jewish Evangelism
Youth/Children"s Activities
Personal Evangelism
Drama Productions
Leading a Bible Study
Preaching
Leading Worship
Event Planning
Community Outreach
Praying Publicly

What would you hope to achieve through your involvement with Jews for Jesus and going to Israel?
Reaching Jewish people with the gospel is important to me because...
Describe something you feel was uniquely Jewish about your upbringing.
What do you feel God has specfically called you to do?
What spiritual gifts do you feel God has given you?

EncouragementMercyTeachingFaithHealingPropheticServingLeadershipGiving
How frequently do you study the Bible?

NeverRarelySometimesOn a regular basis
Please explain:
Describe your prayer life:
Do you financially support any ministries on a regular basis? If so which ones?

HEBREW PROFICIENCY

	None	Beginner	Intermediate	Fluent
Reading in Hebrew
Writing in Hebrew
Speaking in Hebrew

Can you read and write the alef-beit?

YesNo
GENERAL HEALTH
Massah may be physically demanding. Health conditions will not necessarily disqualify applicants from participating, but must be considered. Please answer all questions in this section.
Rate your general condition of health:

ExcellentGoodFairPoor
Do you smoke:

YesNo
Have you abused alcohol or drugs in the past 3 years?

YesNo
If yes, please explain:
Are you presently under a doctor's care for any health condition?

YesNo
If yes, please explain:
Are you allergic to any drugs/medications?

YesNo
Specify:
Are you allergic to any foods or do you avoid certain foods for other reasons?

YesNo
Specify:
Do you now have, or have you ever had, any of the following?

Skin conditionEye troubleEar troubleHead injuryHeadachesEpilepsyDepressionParalysisMental/Nervous disordersInsomniaShortness of breathHay fever/asthmaAllergiesHeart troubleHigh blood pressureLow blood pressureRheumatism/ArthritisBack problemsDislocation of jointsBroken bonesSurgery (list below)PregnancyStomach/Duodenal ulcerJaundiceIntestinal troubleDiabetesAnemiaCancer/Tumors
Irregular periodsExcessive menstrual flowSexually transmitted diseaseHepatitisRecurrent diarrheaKidney diseaseGall bladder problemsSurgery (list below)Severe crampsPregnancyOther
Explanations for above:
Do you have any other health considerations that we should be aware of? Please explain:
If you take any medication, please state the name and amount:
Have you ever been convicted of a felony?

YesNo
If yes, please explain:
PASSPORT AND VISA INFORMATION
Country of citizenship:
Name as listed on passport:
City and county where passport was issued:
Passport number:
Passport expiration date:
Do you have any visas?

YesNo
If so, what type?
Country where visa was issued:
Date visa issued:

MonthDayYear
Date
Visa expiration date:

MonthDayYear
Date
Have you ever been denied a passport or visa?

YesNo
If yes, name the country and provide details:
To what countries have you traveled and for how long?
EMERGENCY CONTACT INFORMATION
Name of emergency contact:*
Relationship:*
Address:
Phone #:*
Email:*
REFERENCES - List the name of one pastoral reference AND one elder or mature believing friend whom we can ask to fill out a character reference on your behalf.
Pastoral reference NAME:
Address:
Phone #:
Email:
Elder/Mature believing friend NAME:
Address:
Phone #:
Email:
I feel the liberty of the Holy Spirit to fill out this application and if accepted I intend to serve on the project for which I am applying. I hereby affirm all of the statements in this application are true and understand that any knowing misstatement of the facts can bar further consideration for participation with Jews for Jesus.
Signature

Clear
Date:

MonthDayYear
Date
Should be Empty:

Massah Project Application

GENERAL INFORMATION