Rochester ShinShinim Host Family Application
We are thrilled that you are considering hosting a young Israeli leader, one of our ShinShinim, in your home. We are currently accepting applications for the 2024-2025 school year. For more information about the ShinShinim program, visit www.jewishrochester.org/shinshinim or contact Michal Spivak, ShinShinim Program Director at mspivak@jewishrochester.org. The following questions will serve us in the matching process.
Prospective Host Family Last Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
-
Area Code
Phone Number
Adult 1 Name
*
First Name
Last Name
Adult 1 Cell Phone Number(s)
*
Adult 1 Work Phone Number(s)
Adult 1 Email
*
example@example.com
Adult 2 Name
First Name
Last Name
Adult 2 Cell Phone Number(s)
Adult 2 Work Phone Number(s)
Adult 2 Email
example@example.com
Children
Children's names
Age
Do they live at home? (please write "college" if away at college)
1
2
3
4
5
6
7
Are there others who live in the home?
Please include all relevant information: Name, age, gender
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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:
*
Mid Sept — end of Jan
Beginning of Feb — Mid June)
Interested but can't commit without knowing more. Please contact me.
Other
Please add any date-related info/conflicts/questions here:
including dates you plan to be away
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
On weekends
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:
*
Strictly kosher
Kosher style
Definitely not kosher
Vegetarian
Vegan
Gluten free
Has someone with a serious food allergy
Other
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
Other
If you would like to elaborate on your Shabbat practices, please do so here:
Do you have any pets?
*
Cat(s)
Dog(s)
No
Other
Does anybody in your household smoke?
*
Yes
No
Other
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?
Submit
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