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Bar Mitzvah / Bat Mitzvah Questionnaire

Please fill out this form to help us suggest a meaningful Bar Mitzvah / Bat Mitzvah program, especially designed for you.

If you have ideas of your own, please feel free to share them. We want you to connect with the land and People of Israel!

*First Name  
*Last Name  
*Street Address  
*P.O.Box
*State
*City  
*Zip  
*Email
*Country
*Phone  
Fax
  *Required fields
Is this your first time in Israel? Yes No
Do you speak Hebrew? Yes No
Do you enjoy nature? Yes No
Do you enjoy physical work and/or exercise? Yes No

Please choose one of the following that you think would best suit your interests:
Sharing your Bar Mitzvah / Bat Mitzvah with another Israeli student
Helping disabled people on a horse ranch
Planting trees
Going on a nature adventure
Helping the ill and/or elderly
Helping blind and dyslexic children
Working in an animal shelter
Taking a hike in Israel to connect with the land
Participating in an archaeological dig

Volunteering
How many people will be volunteering with you?
What is the age range of the people who will be volunteering with your?
Share any ideas you have that would make your experience more fulfilling.