Application: Jewish Federation Teen Israel Experience

Jewish Federation of Greater Los Angeles POST Partnership Israel Experience Incentive Grant

Be sure to email your signed Release Form along with a copy of your program acceptance receipt (usually an email from the trip coordinator) to IsraelExperience@Jewishla.org

The Release Form is downloadable on: https://www.jewishla.org/program/israel-experience-grants/

1. Traveler's Last Name *This question is required.

2. Traveler's First Name *This question is required.

3. Email *This question is required.

4. Address *This question is required.

5. ZIP CODE *This question is required.

6. Traveler's Birthdate *This question is required. This question requires a valid date format of MM/DD/YYYY.

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7. School *This question is required.

8. Grade *This question is required.

9. Israel Travel Program and Session Name *This question is required.

10. Cost of Program (excluding airfare) *This question is required. This question requires a valid number format.

11. Dates of Travel *This question is required.

12. Program Length (in weeks) *This question is required.

13. How did you hear about this grant?

14. PARENT Last Name *This question is required.

15. PARENT First Name *This question is required.

16. PARENT Email *This question is required.

17. Secondary PARENT Email

18. Best Phone Number to Contact *This question is required.

19. Has the Traveler been to Israel before? *This question is required.

20. If Yes, please provide the program name/purpose and date of previous Israel visit(s).