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Application form

General Information

1. How did you hear about Yeshiva Gedola Berlin?

 My Friends

 My Rabbi

 Internet Search

 Facebook

 Other
 

2. Prefered Arival Date

3. Prefered departure from Yeshiva Gedola Berlin

4. Contact information

5. Hebrew Name

6. Date of Birth

Jewish Background

7. Were you born Jewish?

 Yes

 No

8. Did you convert to Judaism?

 Yes. What is the name of the converting rabbinical court?

 No

9. Was your mother born Jewish?

 Yes

 No

10. Did your mother convert to Judaism?

 Yes. What is the name of the converting rabbinical court? 

 No

11.  Was your maternal grandmother born Jewish?

 Yes

 No

12. Did your maternal grandmother convert to Judaism?

 Yes. What is the name of the converting rabbinical court?

 No

Health

13. Please list any dietary restrictions (vegetarian, vegan, no red meat, no dairy, etc).

14. Have you been hospitalized in the past?

 Yes. Please list the details for each hospitalization.

 No

15. Have you ever received psychological treatment and/or counselling in the past?

 Yes. Write

 No

16. Are you currently taking any medications?

 Yes. Please lease list each medication.

 No

17. Please list any restrictions on activities (swimming, hiking, etc.):

18.   I agree to pay for any costs associated with mental health treatment that may not be covered by my insurance should Yeshiva Gedola Berlin’s mental health professionals determine that I am in need of such.

General Education

19. What is the highest level of education that you have already completed?

20. Elementary School

Name

21. Secondary/High School

Name

GPA  

22. University

Name

GPA  

Jewish Education

23. Which synagogue or temple do you affiliate with, if any?

Name

24. Personal References

25. Did you receive any formal or informal Jewish education?

 Yes (describe)

 No

26. Were you involved in any Jewish groups?

 Yes (describe)

 No

Motivation Essay

27.  Describe your motivations for applying to Yeshiva Gedola Berlin. (Approximately 300-400 words)

Goals

28. What are your Yeshiva Gedola Berlin goals? *This question is required

Choose your goals (at least two) from the list below and rank them in the table provided.

 Meeting new and likeminded people

 Growing spiritually

 Acquiring skills for independent textual learning

 Attending inspiring lectures and workshops

 Studying Jewish mysticism (Chassidut)

 Living and learning in Berlin

 Being in a warm environment

 Touring and experiencing Germany

 Learning how to build and maintain a Jewish home

29. If you have any other goals, please describe them here.

Photo

30. Please send us your photo by e-mail (info@yeshivagedola.de)