MARCH OF THE LIVING - TEEN APPLICATION

  • MARCH OF THE LIVING - TEEN APPLICATION

  • This application will take about 20 - 30 minutes to complete.  You will need your passport information and health insurance information to complete the process. If you do not have a passport or if your passport will expire prior to October 30, 2018, you must apply for one now. It can take months to get a new one and we need this information as quickly as possible for security purposes and to make international plane reservations.

    Do not delay.  Interviewes will be assigned on a first come, first serve basis as completed application packages are received.  We anticipate a record number of applicants, but have limited space available.  Remember, the fee will remain the same as last year for all applicants whose COMPLETED application package is turned in prior to August 25th.

    If you have any questions, feel free to contact Rochelle Baltuch, Director, at 954 660 2077 or rbaltuch@orloffcaje.org

     

     

  • PERSONAL DATA

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  • Date of Birth*
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  • FOR STUDENTS WHO ARE ISRAELI CITIZENS OR WHO HAVE AT LEAST ONE PARENT WHO IS AN ISRAELI CITIZEN:  You will need an exemption ("PATOR") from Israeli military service to depart Israel.  A copy will need to be in our office prior to January 1st.

  • Do/Did either of your parents hold Israeli citizenship?
  • Do you hold Israeli Citizenship?*
  • Do you have a "pator"?*

  • FAMILY BACKGROUND

  • Parent 1 is...*
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  • Parent 2 is ,,,*
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  • EDUCATIONAL DATA

  • Jewish Education - Check all that apply*

  • PERSONAL PROFILE

  • Have you traveled (check all that apply)*

  • Have you been to*
  • What are your special interests or hobbies?*

  • Do you play a musical instrument?*
  • Would you bring it on the March*
  • Do you sing well?*
  • Have you had a significant loss in the last 2 years?*
  • Do you belong to a synagogue?*
  • Would you be willing to help with religious services (ie lead songs, English reading, prayers, etc)
  • Indicate all of the social networking sites you use.

  • Have you ever been in trouble with the law?*
  • Have you ever been suspended/expelled from school or any activity, whether or not school related?*

  • In the space below, write a short paragraph on why you would like to participate in the March of the Living. 

  • MEDICAL INFORMATION

    It is our intention to rely on the medical information you submit below, along with the physician's form (to be sent separately) and any supplementary letters from specialists or mental health professionals in determining your acceptance and continuation in this program. Omissions or misstatements are at your risk and that of your physician(s) or therapist(s).

    Should you be found to have any condition, mental or physical, that is not fully disclosed on this form, the physician's form or in an accompanying letter from an appropriate, qualified medical or mental health professional, you may, at the sole and absolute discretion of the program, be returned to the USA at your own/family expense, or be treated in the country(ies) you are visiting, at your own/family expense, and there shall be no refund of monies paid.  The leadership of this program and its sponsoring organizations are hereby released from all responsibility or liability of any kind whatsoever arising out of any aspect of your medical history and mental or physical condition.

    If any changes take place in your medical or mental condition prior to departure of this program, you must immediately submit a full explanatory letter, signed by an appropriate, qualified medical or psychological professional, detailing your diagnosis, prognosis, and treatment. Failure to submit such a report may result in your expulsion from this program with no refund of fees.

  • Please mark the box(es) next to any medical condition listed below which applies to your health history.

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  • Do you have allergies?*

  • The March of the Living provides 3 kosher meals per day.  At the interview we will discuss any dietary requirements listed below.

  • Are you/Do you

  • In consultation with my parent(s), in checking the "Yes" box below, we certify that I am able to participate on the March of the Living, understanding that the trip is strenuous with early wake ups and late curfews, frequent and sometime long bus travel, and many hours of standing and walking.   We further agree to immediately send our physician the Medical Form which must be completed and returned to our office PRIOR TO the required interview.

  • PAYMENT AND CANCELLATION POLICIES

  • I have reviewed this application with my parent(s)/guardian.  All questions have been answered honestly.  I will also share the payment and cancellation policies found below with them.

    The fee for the 2018 March of the Living is $6225 (does not include domestic air fare), subject to a possible 5% increase from the Int'l March of the Living).  As indicated on our website, we are hold the fee to last year's ($5995 plus domestic air fare) for those who submit a COMPLETED application package prior to August 24, 2017.  

    Need based FINANCIAL ASSISTANCE is available through an allocation of the Jewish Federation of Broward County/Jewish Community Foundation, monies from an endowment fund of the Friends of the March of the Living and individual donors.  Information of applying is on the Orloff CAJE website  Click here for a direct link

    Remember the deadline for financial assistance is October 15th.  Only completed application packages will be considered.

    PAYMENT:  

    With application:  $500 deposit ($200 is non refundable until interview.  After                                         interview it is not refundable.)

    Due September 15:  25% of balance

    Due October 15:      25% of remaining balance

    Due November 15:   25% of remaining balance

    Due December 15:   Remainder of balance due

    CANCELLATION POLICY - NON REFUNDABLE AMOUNTS

    If cancellation is between application & interview                    $200

    If cancellation is between interview & October 31, 2017           $750

    If cancellation is between November 1 & November 30, 2017   $1300

    If cancellation is between December 1 & December 31, 2017    $1775

    If cancellation is between January 1 and January 31, 2018        $2275

    If cancellation is between February 1 and February 28, 2018     $3375

    After February 28, 2018                                                     No refund

     

    For questions or additional information, contact Rochelle Baltuch,

    954 660 2077 or rbaltuch@orloffcaje.org

     

    Thank you for your application.  Please remember to submit your deposit.

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