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Home
Israel
About Israel Trip
Next Trip Dates
Sample Itinerary
Photos of Israel
Aaron’s Trip Diary
Poland
About Poland Trip
Next Trip Dates
Sample Itinterary
Poland Photos
Stateside
About Stateside Trip
Next Trip dates
Sample Itinerary
FAQ
Rabbi Klatzko
Media
Videos
Testimonials
Contact
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Trip Info
Which Trip are you Applying for?
*
Israel
Poland
Stateside
Akiva 2 (Advanced Learning Program)
Akiva 1 Trip Dates
*
May 9 - 25, 2016
Aug 15 - 31, 2016
Jan 3 - 15, 2017
May 14 - 29, 2017
Aug 7 - 23, 2017
May 22 - June 7, 2018
Aug 20 - Sept 5, 2018
Dec 17, 2018 - Jan 2, 2019
May 14 - 29, 2019
Aug 11 - 27, 2019
January 5 - 21, 2020
June 1 - 17, 2020
Aug 10 - 26, 2020
Aug 9–25, 2021
Dec 27, 2021 – Jan 12, 2022
June 13th – 29th, 2022
Aug 8th – 24th, 2022
Dec 19, 2022 - Jan 4, 2023
May 29 2023- June 14, 2023
July 31, 2023 - August 16, 2023
Please select which Akiva 2 Trip you will be attending
*
Jewel
Jewessence
Neve
I don't know / other
Please select which Akiva 2 Trip you will be attending
*
If you are unsure about these options, select the "I don't know" option and someone will contact you.
Essentials
Ohr Somayach
I don't know / other
Select Jewel Trip Dates
*
May 29– June 22, 2016
June 26 – July 20, 2016
July 24 – Aug 17, 2016
Other
Select Essentials Trip Dates
*
December 28 - January 13, 2016
January 14 - February 1, 2016
February 2 - February 22, 2016
February 23 - March 14, 2016
March 15 - March 30, 2016
March 31 - April 18, 2016
May 3 - May 18, 2016
May 19 - June 6, 2016
JInternship May 29 - Jul 20, 2016
June 7 - June 27, 2016
June 28 - July 18, 2016
July 19 - August 15, 2016
Aug. 17 - September 1, 2016
September 4 - September 20, 2016
September 21 - October 13, 2016
Other
Poland Trip Dates
*
Dec 26, 2016 - Jan 3, 2017
Mar 13 - Mar 19, 2017
March 19 - 26, 2018
Mar 10 - 17, 2019
March 16 - 22, 2020
July 13 - 19, 2020
Jan 3 – 11, 2022
March 9 – 15, 2023
TBD
Stateside Trip Dates
*
Jan 8 to 15, 2018
Dates TBA
From Date
MM slash DD slash YYYY
To Date
MM slash DD slash YYYY
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Please specify your Campus
Trip Cost Varies by Campus
University of Texas
Washington University in St. Louis
Please specify your Campus
*
UF - Gainesville
UCF - Orlando
Please specify your Campus
*
ASU - Arizona State University
U of A - University of Arizona
University of Indiana
Other
Trip Cost for your Campus:
$699 All Inclusive
(subsidized by your campus)
Trip Cost for Other Campus:
$999 All Inclusive
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United States
Canada
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South Africa
Israel
Afghanistan
Albania
Algeria
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Chad
Chile
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Costa Rica
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Have you ever been on any organized Israel Trips?
*
Misrepresenting this information will disqualify you from the trip.
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Please list the names of the trips that you have been on?
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It is very important that you list EVERY organized trip you have been on. Omitting any information will jeprodize your acceptance to Akiva.
How did you hear about Akiva?
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Employment Information
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Check if unemployed / in school
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Current Employer:
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Your Contact Information
Your Current Address:
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Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
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Bouvet Island
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Cook Islands
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Panama
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Russian Federation
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Saint Lucia
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Samoa
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Senegal
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Sierra Leone
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Solomon Islands
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Ã…land Islands
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Living Situation:
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Check if same as address above
Same Address
Permanent Residence Address:
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Afghanistan
Albania
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American Samoa
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Angola
Anguilla
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Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
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Côte d'Ivoire
Denmark
Djibouti
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Dominican Republic
Ecuador
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Equatorial Guinea
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Falkland Islands
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Germany
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Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
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Macao
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Myanmar
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New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
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Northern Mariana Islands
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Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
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Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
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Saint Kitts and Nevis
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Saint Martin
Saint Pierre and Miquelon
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Samoa
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Sao Tome and Principe
Saudi Arabia
Senegal
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Seychelles
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Solomon Islands
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Thailand
Timor-Leste
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Zambia
Zimbabwe
Ã…land Islands
Country
Family Background
Mother's First Name:
*
Mother's Last Name:
*
Mother's Occupation:
*
Father's First Name:
*
Father's Last Name:
*
Father's Occupation:
*
Was your birth father born Jewish?
*
Yes
No
Was your birth mother born Jewish?
*
Yes
No
Were all your grandparents born Jewish?
*
Yes
No
Please summarize fathers conversion history if any:
Please summarize mothers conversion history if any:
Please summarize grandparents Jewish history:
Parents Marital Status:
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Parents Jewish Affiliation:
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Please specify Parents Jewish affiliation:
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Educational History
What extracurricular activities, hobbies and organizations are you involved in?
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What Jewish Education have you had?
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Please Select
Virtually None
Hebrew School/Sunday School (pre age-13)
Hebrew School/Sunday School (post age-13)
Jewish Day School
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How would you describe your Jewish education?
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How are your Hebrew skills?
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I can only Read (fluently)
I can only Read (not fluently)
I can Read and Speak (fluently)
I can Read and Speak (not fluently)
I cannot Read or Speak Hebrew
Do you hold any leadership/professional positions in Jewish organizations?
*
Yes
No
Position:
*
My top 4 life priorities are:
1
*
2
*
3
*
4
*
Character References
Please include name, address, phone, relationship to you and the best time of day he or she can be reached. Please do not include family or friends
Reference 1 - Name
*
Relationship to Reference:
*
Phone:
*
Best time to call them:
Reference 2 - Name:
*
Relationship to Reference:
*
Phone:
*
Best time to call them:
Special Requirements
Do you have any accessibility requirements or physical limitations or restrictions?
*
Yes
No
Please elaborate:
*
Do you have any special dietary requirements?
*
Yes
No
Please elaborate:
*
Are you currently receiving medical treatment or psychological counseling?
*
Yes
No
Please elaborate:
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Are you currently taking any medication?
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No
Please list your medications:
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Have you ever been hospitalized?
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Yes
No
Please explain:
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Survey
How do you identify yourself?
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Primarily American
More American than Jewish
Equally American and Jewish
More Jewish than American
How is Torah relevant to you?
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Not relevant
Only Culturally
Nice practical ideas and ideals
A serious source of wisdom
How often do you learn Torah?
*
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Not Regularly
Monthly
Few time a Month
Weekly
Few times Weekly
What is your attitude toward marrying someone Jewish?
*
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Religion is not important
Nice, but not a criteria
Prefer Jewish but will date non-Jews
Will only date and marry Jewish
Will your children's education have:
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No extra Jewish emphasis
Extra curricular Jewish schooling
Any Jewish day school
Orthodox Jewish day school
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Your Sweatshirt Size:
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Please note: Israeli sizes run smaller than U.S. sizes. You may want to select 1 size larger.
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Would you like to be contacted about ordering an Israeli phone, sim card or mifi device for the trip? (highly recommended)
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Someone from the phone company will contact you about ordering the best device to fit your needs. All orders will be waiting for you when you arrive in Israel.
Yes
No
Do you have your Passport information available right now?
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Passport Number:
Passport Expiration Date:
Olami Terms
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With programs in over 30 countries, Olami and its funding partners sometimes use independent verification firms to assure that programs are attended and impactful. By registering, I understand that I might be contacted by a verification firm for quality control purposes.
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Mosaic Terms
Olami is funded in part by Mosaic United. Uncheck this box if you don't want to be contacted regarding future Mosaic sponsored-opportunities.
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