Programs

  5 Months Volunteer in Israel with Livnot Taglit - birthright israel Young Jewish adults program at Livnot Galilee Fellowship

Application Form
Five Month

  • Applications are processed on a first-come, first-served basis.
  • If you can take a few more minutes to fill out the additional information, it would be very helpful to us.
  • Be sure to indicate the program date of your choice and an alternate program date.
  • Please register once only. After submitting this application, you will receive an automatic e-mail message acknowledging receipt.
  • Please double check the information before submission. It is recommended to print a copy of your filled out application.
  • If, for some reason, you do not receive an email acknowledgment of the application, please contact our office via phone or email.
Note: Fields marked with * are required.
* Requested program date:

General Information

Please enter your legal name as it appears on your passport.
*
First Name:
*
Last Name:
 
Hebrew Name:
*
Gender:
Male Female
Passport Number:
* Date of Birth:
* Marital Status: Single     Married     Divorced    Widowed
Permanent Address
*
Street:
*
City:
*
State:
*
Zip:
*
Country:
*
Phone:
 
Cellphone: (If you are currently in Israel, please include your Israeli cell phone number or other number to reach you at)
 
Fax:
*
Email (main):
*
Confirm Email (main):
 
Email (secondary):

Tell us about yourself

Education

 
 

High School/Location:

 
Year Graduated:
 

University:

 
Program of Study or Field:
 
Dates:
 

Graduate School:

 
Program of Study or Field:
 
Dates:
 

Present Employer:

 
Position:
 
Date you started in this position:
 

Professional or vocational training:

Jewish Education  
 
Type:
Sunday School     Day School     Hebrew School
 
No. of years:
* Taglit birthright israel (Alumni or Summer 2007 participant):
* Religious Affiliation:
 

Courses in Judaica (college, synagogue, other):

* Have you ever been to Israel before? No    Yes
  Purpose of trip, dates and duration:
  Level of Hebrew: None    Basic    Moderate    Fluent
  How did you hear about Livnot U'Lehibanot?
Please be specific as possible.    
* Heard from:
  Please specify name of source:
   
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Applicant's Statement

Upon submission of your application you agree to the terms and conditions of Livnot U'Lehibanot.
Please read our terms and conditions.

Please submit your $150 deposit (which includes the $50 non-refundable processing fee) after submitting this form. You can also access the online payment for here.

Applications will be processed when the deposit has been received.

Also, you will soon receive a confirmation message. Please follow the instructions in the message.
  Amount Description
     

$150 Deposit Five Month program ($50 is non-refundable application fee)


Balance for Five Month program
  Total

Please scroll the frame to read our Terms & Conditions. When you are done, please check the box at the bottom of the frame. The box must be checked when submiting this form.

Livnot Terms & Conditions
  1. Deposit / Non-Refundable Application Fee:

    $50 of the deposit amount is a non-refundable application fee. If Livnot cancels the program then the deposit, including the $50 non-refundable application fee will be refunded to the participant or credited towards a future Livnot program.

    A person who is confirmed for a program who cancels 21 days or less prior to program forfeits the remainder of thier deposit.
     
  2. Space Allocation:

    Spots on Livnot programs are allocated on a first-come, first-serve basis to those applicants who have completed the application process, including an interview, completion of all forms, requirements and payments of deposits and fees.
     
  3. Livnot Programs that have airfare included as part of the tuition fee:

    1. After a applicant :
      a) applies
      b) is accepted
      c) confirms their acceptance and
      d) their ticket is issued by airline,
      If at this point they cancel for any reason, they are required to pay the full cost of the airfare, which was reserved for them and in addition they lose their deposit. The reimbursement to Livnot for the cost of ticket will go on the applicant's credit card that the deposit was made with, unless other arrangements are made.
       
    2. Conditions for changing return flight:
      All changes are made directly through the issuing airline and may only be made upon arrival in Israel for the Livnot program with which you applied. In the event the same class is not available, the person is responsible for the price difference. This fee is subject to change and is determined by the issuing airline.
    3. If a participant is asked to leave the program due to a violation of Livnot's program rules as determined and decided by Livnot staff based on Livnot's code of conduct and program policy, or if a participant leaves a program without consent of the program coordinator prior to the ending date of the program, the participant is financially responsible for the cost of the full, round trip airfare ticket. In such a case, reimbursement to Livnot for the cost of ticket will go on the applicant's credit card that the deposit was made with, unless other arrangements are made.

     
  4. Living Arrangements:

    During the program, Livnot is responsible to provide reasonable living accommodations as determined by Livnot staff. A person who requires different arrangements for health or other reasons bears all financial responsibility for those arrangements, including any and all payments and fees.
     
  5. Medical Coverage:

    It is essential that you travel with your own Travelers Insurance, as your coverage during the program takes affect only on the day the program begins. All Livnot participants are insured during the duration of the program. The Health Insurance taken out on your behalf does not cover any pre-existing medical conditions. Medication, whether prescribed or otherwise, is the financial responsibility of the participant.
     
  6. Free Time and Free Week-Ends (when applicable):

    The participant is responsible, financially and otherwise, for their transportation, room, board and other expenses while on free time and free weekends, as well as their safety. During free weekends, participants are required to leave the Livnot facilities. Participants may be required to move all belongings and baggage into a space designated by Livnot staff.
     
  7. Safety and Security

    Participants are required to follow all safety and security guidelines as defined by Livnot (these safety and security guidelines are in accordance with those of the Society for the Protection of Nature in Israel). This is true throughout the duration of the program, on hikes, tours, at all facilities and during any and all programmed free time. Livnot staff instructions, whether written or verbal, are to be followed at all times for the safety and security of the participant, staff and group and any and all others interacting or connected with the program and/or group in any way. Livnot is not responsible for program participant's safety or where they decide to travel to, during free weekends. The well-being of the participant on free weekends is their own responsibility. Livnot responsibility resumes upon the participant's return to Livnot (such location to be defined by Livnot program staff).
     
  8. Married Couples:

    Livnot will make a reasonable effort to provide a married couple with joint living arrangements. These decisions will be based on space, room availability, financial considerations and group dynamics issues. There may be times when a couple will be separated to male/female rooms with other roommates if the need arises. Livnot reserves the right to make such decisions as it sees fit.
     
  9. Dietary Restrictions:

    Livnot makes every effort to accommodate people's individual dietary needs to a reasonable degree, as determined by Livnot staff. In the event that a person's dietary needs cannot be accommodated, as decided upon by Livnot staff, the participant becomes financially responsible for his/her own requirements.
     
  10. Minimun number of participants:

    Outdoor Expedition, Hike & Explore, 30somethings and Classic Livnot Programs require a minimum of 15 participants.
     
I read the terms and conditions and agree.