Application for JAM Trip
Note: If approved there is a $50($25 for NY Trip) non refundable application fee to be paid online after submitting the application.
Your application fee will be refunded if you are not accepted on this trip.

 Contact Information

 First Name
 Last Name
 Which trip are you applying for?
 There is a fee due after the application (Required)
 Date of Birth
 If Other (specify)

 Home Address


 Cell Phone

 E-Mail Address

 Family Information

 Father’s Name
 Mother’s Name
 What is your father's occupation?
 What is your mother's occupation?
 Parent’s Phone Number
 Where was your father born?
 Where was your mother born?

 Parent’s Marital Status

 Is your Mother born Jewish?

 Is your Father born Jewish?

 List the names, ages of your siblings and whether any of them are in college right now : (John Doe in/not in college).





 Educational Information

 Current year in school
 Which high school did you attend?
 Have you visited the Trips destination in the past?
If so with what organization?
Please a recommend a friend that may be interested in this or other JAM Trips.
 Cell Phone
 College Info
 Email Info
 List the extracurricular activities you have been involved in (including high school) and describe your participation.

Miscellaneous Information

 Do you have any “formal’” Jewish Education?  If so, please list the Jewish schools you attended together with the dates.

 Have you ever sought psychological counseling?
How did you hear about this trip, or who referred you?
 Are you or have you been, a member of a Jewish organization?  If so, which one.

 Describe your Jewish observance:


 Are you taking any type of medication?

 Do you have any special medical need?

 Do you know people coming on this trip or any of our other trips?  If so, who?

 What are your life's top four priorities?



Thank you for completing this application form and for your interest in joining our JAM Trip.


What role do you see Judaism “playing” throughout your life and

why are you interested in joining this trip?

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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.
Olami is funded in part by Mosaic United. Uncheck this box if you don't want to be contacted regarding future Mosaic sponsored-opportunities.