| * First Name: |
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| * Last Name: |
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| * Gender: |
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| * Date of Birth: |
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| * Semester for which applying: |
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| Your Address at
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| State: |
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| Zip Code: |
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| School Phone: |
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| * Email address: |
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Family Background: |
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| * What religion were you born into? |
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| * Into what religion was your biological mother born? |
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| * Into what religion was your biological father born? |
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| * Into what religion were your maternal grandparents born? |
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| * Into what religion were your paternal grandparents born? |
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| * Given your family's religious history, with which religion do you associate yourself with today? |
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| Please provide details, including details of any conversions. |
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Please list the names and ages of your siblings:
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| Do you have any special health needs? |
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Explain:
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| Are you currently taking any medication? |
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Explain:
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| * Who referred you to this program? |
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| General Education History: |
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| Jewish Education History: |
| * What is the highest level of Jewish education with which you've been involved? |
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| If you attended afternoon Hebrew School, how many years did you attend? |
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| What was the Jewish affiliation of your Hebrew School? |
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| If you attended Jewish Day School, till what grade did you attend? |
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| What was the Jewish affiliation of your day school? |
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| How would you describe your current Jewish affiliation? |
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| How would you describe your Hebrew speaking skills? |
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| How would you describe your Hebrew reading skills? |
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| Please describe any leadership/professional positions you’ve held in Jewish organizations. |
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| What Jewish schools (if any) did you attend? |
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| What other types of Jewish experiences have you had? (Bar/Bat Mitzvah, Youth Group, Fraternity/Sorority, etc.) |
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* In two paragraphs,
please explain what you hope to gain from the Vaad.
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| All personal information will be held in
strict confidence.
I affirm that all the information provided in this application is
true, and understand the Vaad guidelines enumerated
below:
1) I understand that in order to receive the full fellowship I
will need to attend all the program components including weekday seminars,
weekend events, and graduation. I also understand that failure to attend the
above-stated events will result in a prorated deduction from program stipend.
2) I will comply with all basic standards of program conduct in a
manner befitting a Vaad fellow. Meor reserves the right to ask any fellow
to discontinue participation for any reason it sees fit. In such event the
student will not receive any Fellowship funds.
3) A personal interview may be required before final admission. |
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