Masa Membership Application Form

Please make sure your e-mail address is entered correctly

Day/Month/Year

Please note - to be eligible for Masa Membership, your program must be at least 4 months in length

Day/Month/Year
Day/Month/Year

Please read all of the questions extremely carefully as they impact your eligibility.


I meet all the eligibility requirements for Masa Membership

Onward alumni of programs from after May 2016:  A representative will be in touch with you shortly to discuss your eligibility for Masa funding, which is not yet final.

Thank you for your patience until that time.

To complete your application process, please scroll down to read and accept the Terms and Conditions for Masa Israel’s registration.
 

I, the undersigned, am participating in a Masa Approved Program organized by a Masa

Approved Organizer, (hereafter: 'the Program' and 'the Organizer'), under the auspices of Masa Israel Journey (hereafter: 'the Company'). Masa Israel is a joint initiative by the Government of Israel and the Jewish Agency for Israel.

Note: For Participants younger than 18, a Parent/Guardian must sign on their behalf.

I hereby agree, declare and accept that:

 

A.   I will remain in Israel until the end of the Program. I will not travel abroad unless permitted to do so, or during my free time during the course of the Program, In accordance with Masa Israel’s terms and the conditions established by the Organizer, and on condition that the vacation is not taken at the start and/or at the end of the program.

 

B.   I will convey to the Organizer, in writing or verbally, all relevant information pertaining to my legal status in Israel. I will provide all necessary documents attesting to my status. I will also advise the Organizer of any change in my legal status.

 

C.   I will participate fully in all activities, meetings, tours and hikes included in the Program, especially (but not only) main Masa Israel events, as determined by the Company.

 

D.    I am aware of all my obligations, privileges and limitations regarding my stay in Israel during the Program, especially (but not only) as they pertain to safety and security instructions.

This applies equally whether I am on campus (or another base of activities), on hikes, during my free time, at organized host family events, or during travel and visits abroad, in accordance with the guidelines provided by the organizer that appear as Appendix C&D in the information pamphlet provided by the Program Organizer.

 

E.     I am aware that the Company has no responsibilities or obligations to me with regards to academic and/or other credit for the Program.

 

F.   I acknowledge that details of my participation in the Program will be transferred by the Organizer to the Company.

 

G.   I agree to allow the Company and/or any other who is authorized to request in the name of the Company, to turn to the Ministry of Interior of the Government of Israel and/or other official relevant authorities, so as to obtain information of my status in Israel, and in general, as it relates and pertains to my date(s) of entry(ies) to Israel and/or date(s) of departure(s) from Israel.

 

H.   I am aware that neither the Company, nor the Government of Israel, nor the Jewish Agency for Israel can in any way be held responsible for and have no obligation towards my participation in the Program and/or any other matter that pertains to this agreement. I hereby waive all complaints, demands and/or claims relating to the above. Should I decide nevertheless to submit a claim to the Company, the Government of Israel, or the Jewish Agency for Israel, I will reimburse them in full for any amount they are required to pay for damage or loss incurred by them as the result of my claim and/or as the result of breaching or otherwise failing to comply with the terms of my commitment as laid out here and/or according to law. This compensation will also extend to any legal costs and expenses that are incurred for any of the above reasons.

 

I.    (i) I accept that all of the above will apply in full to another Masa approved Program and Organizer in the event that I transfer from my originally chosen Program to another Masa approved program, or continue with another Masa approved semester program on the completion of my originally chosen Masa approved semester program.

(ii) I understand that to transfer or continue in a second semester program is only permitted where the time period between the end date of my original program and the start date of my second program does not exceed 4 months and that all conditions as at the start of the original program will pertain to the second program as to age and funding eligibility.

(iii) I understand that because there may be differences in categorization between my original Program of choice and the second Program, my participation duration in the original Program and that of the second Program may affect my classification as a “Masa Participant”, and I undertake to clarify this status personally with all relevant parties in both programs (the original Program and the second Program) and ensure that I still meet all that is required of me as a “Masa Participant”, and I shall not approach Masa and/or anyone assigned on Masa’s behalf with any complaint and/or demand regarding this classification (in the event that, for any reason, my financial assistance will be reduced from what I received for participation in the original Program).

 

J.   I give Masa permission to:

ü  Share the information in my application form with donors, potential donors, the Government of Israel, the Jewish Agency for Israel and my Program Organizer.

ü  Use photos taken of me at Masa and Masa-affiliated events in its publications, press releases, and/or on the Masa website.

ü  Use my email, home address or phone number to contact me.

When you click the Submit button below a copy of your application form will be sent as an attachment to the email address you have entered on this form, and to the Program you selected.

If you find any errors, encountered any problems, or if you have questions, there’s no need to submit another form. Simply contact your Program Organizer or the Masa Helpdesk at masainfo@masaisrael.org for assistance.