Application

The Basics

Name as it appears on your passport:

* Indicates required field

First *

Middle *

Last *

Email *

Phone Number *

Address *

City *

Date of Birth (DD/MM/YYYY) *

Gender *

The Details

Passport Number *

Passport Issuing Country *

Passport Expiration Date *

Most of the program is conducted in English. Are you comfortable with that? *

Yes No Let's talk about it

We recognize that it can be difficult to share sensitive information around health and ability. We ask because it is extremely important to us that we are able to create the conditions that allow participants to thrive while participating in the Weekly Learning Group.

Do you have any physical or learning challenges that you want to be in conversation about for transportation, travel, communications, or other aspects of the Learning Group? If yes, please explain. *

Please tell us about any dietary restrictions or allergies. *

Achvat Amim works closely with a number of communities that experience vaccine inequality and are more vulnurable to the negative affects of Covid-19 (including limited access to medical care, lost wages, and increased sickness from lack of vaccines). In order to protect our partners, speakers, and each other, Achvat Amim requires that all participants have a Covid-19 vaccine and booster shot.

Do you expect to be vaccinated with a booster shot by October 2023? *

Yes Let's talk about it

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

Emergency Contact Email *

We know that money may bring pain, shame, and heartbreak. We are here to have conversations with you and are strongly committed to resourcing you in order to make joining the Sunday Learning Group a reality.

The cost of the Sunday Learning Group is sliding scale, between 4100 and 5400 NIS. If you are accepted to the program, you will fill out a form stating the tuition you will pay for the Weekly Learning Group and, if you would like, set up a payment plan. If money is the primary barrier to your participation, we can discuss additional scholarships and forms of financial support during your interview.

You can find information about the cost of the Sunday Learning Group here.

I would like to discuss additional additional scholarships and forms of financial support *

Yes No

Getting to Know You

This isn't a test. We are just interested in finding out more about you, your motivations, interests, etc. Try to keep your answers under 250 words.

Tell us a little bit about yourself! What do you do? *

Why do you want to join the Learning Group? What do you hope to get from this learning program? *

Upload your CV or Resume *

Max file size: 20MB

What questions, concerns, thoughts or otherwise do you have? *

How did you hear about us? *

Please specify. If you saw an ad online, where? If you heard from a friend, who? etc. *

Submit

Apply HereWeekly Learning Group

The Basics

The Details

Getting to Know You

Apply Here
Weekly Learning Group