Please fill out the following application. Once you submit it, it will be reviewed by the Foundation. After approximately 7-10 days, you will be contacted. If you are approved, you will then arrange a pickup at the Jeff Seidel Student Center Old City Office by calling 02-628-2634 during business hours (930-430)

First Name  
Last Name  
Age  
Gender  
Is your mother Jewish?  
Is your father Jewish?  
Jewish background if any?  
Why do you need a Prayer Book?  
Current Jewish affiliation  
How did you hear about this promotion?  
Email Address  
Phone number in Israel?  
Phone Number abroad?  
University  
Address Abroad  
City  
State  
Zip  
When do you plan on leaving Israel?  
Add a photo of yourself  
Please check which one of the following you would like (while supplies last)   1. Siddur (Prayer Book)

2. Stone Edition ENGLISH ONLY Tanach (Bible)

3. English/Hebrew Tehillim (Psalms)

4. Womens Prayerbook

5. 2013 Jeff Seidel Jewish Travelers Guide