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Financial Aid & Aliyah Services Application

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For Internal Use Only GFA_0411016_UK Nefesh B'Nefesh Services Nefesh B’Nefesh aims to ease the financial burden associated with Aliyah by providing a financial buffer for Olim and helping supplement the requisite relocation expenses, thereby alleviating the somewhat prohibitive costs of Aliyah. We provide support to our Olim both before and after their Aliyah for employment, social services and government assistance, in order to help make their Aliyah as seamless and successful as possible. Below is a brief description of the services and resources available to Olim.

Financial Absorption - Klita The costs associated with pilot trips, finding a home, Our Absorption Department is ready to assist Olim with and purchasing and shipping household appliances and questions regarding Oleh benefits, government processing, furnishings can be challenging. Often it takes several years or any other aspect of their absorption. The answers to to earn and save enough funds necessary for the move. many frequently asked questions about Aliyah and benefits For a family, by the time the requisite amount is saved, the can be found on our website (see below). children are invariably at an age that makes a move difficult socially, linguistically and educationally. Guidance and Community Resources To obviate these fiscal obstacles, Nefesh B’Nefesh Our Guidance and Community Resources Department provides financial aid to each eligible individual or provides guidance or referrals in matters of education, family to enable them to make their dream of Aliyah community, summer programs, ulpanim and physical or a reality. All financial aid provided to each Aliyah mental health. It also assigns buddy families to help Olim candidate will be vested three years after Aliyah. If in the inital stages of their klita. the candidate emigrates from Israel within three years, Online Resources the candidate will be obligated to return the financial aid NBN Website: We are constantly updating our website (grant) to Nefesh B’Nefesh. with Aliyah resources, contacts and useful information Pre-Aliyah and links. Find us at www.nbn.org.il Our Pre-Aliyah Department assists Olim in all areas NBN Yahoo Group: We have set up a Yahoo of their Aliyah planning. Our expert Pre-Aliyah staff discussion group for our applicants and veteran Olim answer all questions regarding the Aliyah process. This for exchanging advice, contacts and community department is also responsible for grant allocations and information. To sign up, email for overseeing the application review process. [email protected] Employment NBN Singles Yahoo Group: There is a unique Yahoo Our Employment Department helps Olim who are seeking group specifically for Single Olim: To sign up, email: assistance in finding employment, job retraining, career [email protected] development, or professional mentoring.

Eligibility for Financial Aid Please note that Nefesh B’Nefesh may at any time change the terms and conditions for financial eligibility. Please check our website regularly for any changes. Please also note that all financial records are kept in utmost confidentiality.

• Applicants for financial aid must be passport holders of • Both singles and families are eligible for financial either the United States, Canada or the United Kingdom. assistance. • Financial aid is awarded to individuals or families • Applicants must NOT have made Aliyah previously. based on financial need. Applicants who are assessed • Grants will only be awarded to applicants who have as having sufficient funds for Aliyah will not be been approved for Aliyah by the Misrad Hapnim, and awarded financial assistance. If you are unsure as to provide copies of their Teudat Zehut and Teudat Oleh. whether or not you qualify for financial assistance, please feel free to contact our Executive Director, Rabbi Yehoshua Fass, directly via email ([email protected]. Please Note: Nefesh B’Nefesh funding is only il) before starting the application process. available to those applicants who have resided in Israel for less than 5 years. Eligibility for Guided Aliyah Before applying for Guided Aliyah please read the following guidelines to confirm that you are eligible to participate in the Guided Aliyah program.

Applicants must be citizens of the United Kingdom If you converted to Judaism in the United Kingdom: and hold valid passports from the UK. Misrad Hapnim policy requires that you must reside in the community in which you converted for a period of at least If you have: one year before being eligible to make Aliyah. • Served in Machal If you are applying for Aliyah with a newborn child • Converted to Judaism in Israel recently born in Israel (who was not registered as an Israeli • An Israeli passport or were born abroad citizen at the time of their birth) you will have to have a to an Israeli parent US, Canadian or UK passport issued for that child before submitting your application. • A birth certificate from the former Soviet Union or Eastern Bloc If your spouse is an Israeli citizen, and you have children • Renounced Israeli citizenship at any time in the past born abroad, please contact our Absorption Department in order to clarify whether or not your children are considered • Previously been convicted of a crime Israeli citizens and to determine if they are eligible to Misrad Hapnim guidelines dictate that you CANNOT be participate in the Guided Aliyah program. processed through the Guided Aliyah program. In order to apply for Nefesh B’Nefesh assistance, please download and submit an Aliyah via Misrad Hapnim application and contact your local branch of Misrad Hapnim to schedule an appointment to begin the Aliyah process. Application Instructions (Page 1 of 2) Do not submit your application until all of the following steps are complete. Please allow 10 weeks for processing. Please make sure to have all original documents in your possession by the time you submit your application.

Misrad Hapnim Material Teudat Yosher Please complete the enclosed material from Misrad The Ministry of Interior requires that all Aliyah applicants Hapnim (Israeli Ministry of Interior). These forms MUST age 16 and over obtain a Letter of Good Standing be filled out by all family members age 16 and over making (Teudat Yosher) from the authorities in their country of Aliyah. Please photocopy this section as necessary. origin (issued by the country/county/provincial police) “Application for Oleh status” form needs to be filled out certifying that the applicant has no criminal background. for each family member making Aliyah. Apostille certification (also called a chain of signatures or legalisation) must be affixed to the original Letter of Application Good Standing. Guided Aliyah applicants who are unable Please submit your original application and copies of all to obtain this documentation may submit a declaration requested documents. Please retain an additional copy of all signed in the presence of an Israeli lawyer in lieu of the paperwork for yourself. police record. Please find the declaration form attached to the back of this application. Financial Affidavit Complete the financial affidavit (included in application) Passport Photocopies Also, your (the applicant’s) signature is required in order to Please submit a copy of the main page of your US or process the application. Canadian passport (the page which includes your picture) and that of everyone in the family who is making Photo Aliyah. Please include photocopies of all pages indicating Enclose a recent colour photo of all individuals making applicable date extensions, and/or name changes. Your Aliyah. Families: Enclose one picture which includes all passport must be valid for at least six months from your family members together. Singles: Enclose a photo of the projected date of Aliyah. applicant only. Passport Photos Application Fee Please include two official and identicalpassport Application must be accompanied by a cheque(made photos of each family member age 16 and over who is payable to Nefesh B’Nefesh) or cash payment in the making Aliyah. The photos should be in colour, 35 mm amount of 100.00 NIS. wide by 45 mm high, front view, ears showing, and on a Please Note: The application fee is non-refundable. blue or white background. Please print the full name of each Oleh on the back of each photo. Birth Certificates 35 mm Please submit copies of the official birth certificates (NOT a Consular Report of Birth Abroad) for all family members making Aliyah. The birth certificate must list your parents’ names. If the birth certificate is not inEnglish or Hebrew, Head dimensions please submit a notarised translation into English or 45 mm 25 mm wide Hebrew with a copy of the birth certificate. 35 mm high Certificate of Marital Status Please submit a copy of relevant documentation according to your marital status, i.e.: civil marriage certificate, divorce certificate, or death certificate of spouse. All civil documentation issued after September 1, 1988 must be submitted with accompanying apostille certification. If the marital status certificate is not in English or Hebrew, please submit a copy of a notarised translation into English or Application Instructions continued Hebrew with a copy of the marital status certificate. on the next page [ Please make sure to have all original documents in your possession by the time you submit your application.

PLEASE NOTE: Misrad Hapnim reserves the right to ask for additional documents. Application Instructions (Page 2 of 2) Do not submit your application until all of the following steps are complete. Please allow 10 weeks for processing.

Acceptable Proof of Judaism For Parents of Minor Children

Please submit a copy of one of the following: • If you are making Split Aliyah (where one spouse makes 1) Signed letter from a Rabbi from a recognised congregation Aliyah and one does not), Misrad Hapnim requires a in the U.K. on official synagogue letterhead, which states the notarized letter of consent from the parent who is NOT following: making Aliyah authorizing his or her spouse to make • Name, location and telephone number of congregation Aliyah with their children. Please submit a copy of this •Applicant’s full name and parent’s names letter with your application. • Applicant (and spouse, if applicable) is Jewish and born to a Jewish mother • If you or your spouse has minor children from a previ- or ous marriage, Misrad Hapnim requires a notarized 2) Conversion Certificate from a Beit Din (Rabbinical Court) letter of consent from the child’s other parent authoriz- recognised by the Jewish Agency. The certificate must be ing you to make Aliyah (in addition to a copy of your signed by the three members of the Beit Din. divorce agreement/custody order). If the child in ques- tion is making Aliyah, the letter will need to state that PLEASE NOTE: If you converted to Judaism in Israel, you MUST process your Aliyah at the Misrad Hapnim in Israel. the child is permitted to obtain Israeli citizenship. You will need this letter whether your children are making Please note: If you have converted, you must submit your Aliyah with you or not. Please submit a copy of this let- conversion certificate, and an accompanying letterfrom ter with your application. one of the officiating Rabbis describing the details of your conversion that states the following: • Duration of conversion study • Where you studied (e.g. organisation name) • Date of Conversion • If you have children, indicate if they were born before or after your conversion • Community involvement Important note: Please read! Please DO NOT submit original documents with your application to Nefesh B’Nefesh. Please DO bring original documents to your interview with Misrad Hapnim. They will request originals of the following: • Birth Certificate(and notarised translation if applicable) • Civil Marriage/Divorce/Death Certificate with apostille certification (if applicable) • Proof of Judaism • Valid UK Passport • Letter of Good Standing (or declaration from a lawyer) • Notarised letter of parental consent (if applicable) You will need to present these documents to the Misrad Hapnim representative at your interview on a date to be determined. Misrad Hapnim CANNOT process your application without seeing your original documents. Misrad Hapnim will not accept photocopies/faxes. Please note: Misrad Hapnim reserves the right to request additional documents or an interview. Applicant Information For the purposes of your Aliyah processing, please designate one adult in the family as the Primary Applicant and the second adult (where applicable) as the Spouse. 1Section A of this application should be filled out by the Primary Applicant and Section B by the Spouse. A: Primary Applicant Information

Legal Name (exactly as it appears on your passport) Surname First Middle Maiden

Preferred First Name Occupation Gender Male Female

Contact Information

Home Phone Work Phone Mobile Phone Email Address Current Address Street Address City Neighborhood Postal Code

Date of Birth Country of Birth If Israel, at what age did you leave Israel? DD/MM/YYYY

Married Single Divorced Charedi Orthodox Masorti Reform Marital Status Widowed Separated Engaged Jewish Affiliation Liberal Unaffiliated Other Important: Please submit a photocopy of your civil marriage, divorce or spouse’s death certificate, if applicable.

Are you an Israeli citizen? Yes No If yes, what is your Mispar Zehut (Israeli ID #)?

Have you ever held an A1 Visa (Temporary Resident)? Yes No If yes, FROM TO DD/MM/YYYY DD/MM/YYYY If so, what is your 9-digit Israeli ID Number?

Country of Citizenship Please list all countries to which you hold citizenship.

Have you started the Aliyah process Yes No If yes, I opened a tik with Misrad Hapnim Jewish Agency

Date you moved to Israel: How long have you been living in Israel in the past seven years: DD/MM/YYYY Mother's Name: Date of Birth: Father’s Name: Date of Birth: DD/MM/YYYY DD/MM/YYYY Are either of your parents Israeli citizens? Father Mother Neither

Have either of your parents made Aliyah? Mother Date 9-Digit Teudat Zehut No. DD/MM/YYYY Father Date 9-Digit Teudat Zehut No. DD/MM/YYYY

Are you making Split Aliyah? Split Aliyah is when one spouse makes Aliyah and the other spouse will change their status to Oleh at a later date. This is applicable whether or not you have children. Yes No If yes, which spouse is making Aliyah?

Do you or your spouse have minor children not accompanying you on Aliyah? Yes No

If yes, please explain:

Please confirm the total number of family members, including yourself, officially making Aliyah:

Nefesh B’Nefesh website Community Poster Online Word of mouth How did you hear about the Guided Aliyah programme? Advertisment: Please specify publication ______

Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 1 B: Spouse Information - The following info is required even if your spouse is Israeli or not applying for Aliyah. Please submit a photocopy of your civil marriage certificate Legal Name (exactly as it appears on your passport) Surname First Middle Maiden Preferred First Name Occupation Gender Male Female Date of Birth DD/MM/YYYY Country of Birth If Israel, at what age did you leave Israel?

Are you an Israeli citizen? Yes No If yes, what is your Mispar Zehut (Israeli ID #)?

Have you ever held an A1 Visa (Temporary Resident)? Yes No If yes, FROM TO DD/MM/YYYY DD/MM/YYYY If so, what is your 9-digit Israeli ID Number?

Have you started the Aliyah process Yes No If yes, I opened a tik with Misrad Hapnim Jewish Agency Country of Citizenship Please list all countries to which you hold citizenship. Date you moved to Israel: How long have you been living in Israel in the past seven years: DD/MM/YYYY Are either of your parents Israeli citizens? Father Mother Neither Mother's Name: Date of Birth: Father’s Name: Date of Birth: DD/MM/YYYY DD/MM/YYYY Have either of your parents made Aliyah? Mother Date 9-Digit Teudat Zehut No. DD/MM/YYYY Father Date 9-Digit Teudat Zehut No. DD/MM/YYYY C: Children Please provide the information below, if applicable. Please enter full names, as they appear on your children’s passports.

Child 1 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you?

Child 2 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you?

Child 3 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you?

Child 4 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you?

Child 5 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you?

Child 6 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you?

Child 7 Male Female Yes No Surname, First Name, Middle Name (as appears in passport) Gender DOB: DD/MM/YYYY Country of Birth Will this child be making Aliyah with you? Personal Profile For the purposes of your Aliyah processing, please designate one adult in the family as the Primary Applicant and the second adult (where applicable) as the Spouse. Section A of this application should be filled out by the Primary Applicant and Section B by the Spouse. 2A: Primary Applicant Name List any Jewish groups, camps, and/or organisations you have been affiliated with:

History of Experience in Israel Please provide details and dates of your prior visits and time you have lived in Israel on the lines below.

What family do you have in Israel? Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 2 Have you ever served in the IDF or any other armed forces? None IDF Machal Other - please specify:

If you served in Machal, what is your 9-digit Israeli ID Number? FROM TO DD/MM/YYYY DD/MM/YYYY Are you planning to serve in the Israeli Defense Force after your Aliyah? Yes No

Have you participated in a MASA program: Yes No If so, what year and what program?

Education

Secondary School Name of Institution City Country Years Attended Degrees Attained College/University e.g. 1987-1991 Yeshiva Gedola/Seminary Name of Institution City Country Years Attended Degrees Attained e.g. 1991-1995 University/Kollel Name of Institution City Country Years Attended Degrees Attained e.g. 1991-1995 Employment History

I am currently Employed Unemployed Studying Retired Please list your last two jobs, beginning with the most recent: Job 1 Company name Position Held Start Date End Date

What did you like most about this position? What did you like least about this position? Job 2 Company name Position Held Start Date End Date

What did you like most about this position? What did you like least about this position?

Jewish Lineage Were you born to a Jewish mother? Yes No If no, please indicate which of the following options applies to you: My father is/was Jewish One of my grandfathers is/was Jewish My spouse is Jewish (non-Israeli) I converted to Judaism None of the above

Have you or anyone in your family converted to Judaism? Please specify: Self Spouse Mother Father Children None

If so, please indicate the dates of conversion & to whom they apply: DD/MM/YYYY NOTE: Please submit a copy of all conversion documents with application. If any of these conversions took place in Israel, please indicate which conversions:

PLEASE NOTE: If you converted to Judaism in Israel, you MUST process your Aliyah at the Misrad Hapnim in Israel.

Have you ever been convicted of a felony? Yes No If yes, please explain:

Are you currently involved in any legal proceedings? Yes No If yes, please explain:

Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 3 List any stressful events you have experienced over the past two years:

Note: This will not affect eligibility for acceptance to NBN, but will allow us to guide you more concretely through your Aliyah. Are you or any members of your family listed on this application currently taking medications? Yes No

Please list all medications:

B: Secondary Applicant - Complete only if spouse is making Aliyah Name

List any Jewish groups, camps, and/or organisations you have been affiliated with:

History of Experience in Israel Please provide details and dates of your prior experience(s) in Israel on the lines below.

Have you ever served in the IDF or any other armed forces? None IDF Machal Other - please specify:

If you served in Machal, what is your 9-digit Israeli ID Number? FROM TO DD/MM/YYYY DD/MM/YYYY Are you planning to serve in the Israeli Defense Force after your Aliyah? Yes No

Education

Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 4 Employment History I am currently Employed Unemployed Studying Retired Please list your last two jobs, beginning with the most recent: Job 1 Company name Position Held Start Date End Date

What did you like most about this position? What did you like least about this position? Job 2 Company name Position Held Start Date End Date

What did you like most about this position? What did you like least about this position?

Please rate your knowledge of Hebrew: Please circle (poor) 1 2 3 4 5 (fluent) Please circle (poor) 1 2 3 4 5 (fluent) Please circle (poor) 1 2 3 4 5 (fluent) Reading Speaking Writing Are you planning on studying in a Hebrew language Ulpan? Yes No Jewish Lineage Were you born to a Jewish mother? Yes No If no, please indicate which of the following options applies to you: My father is/was Jewish One of my grandfathers is/was Jewish My spouse is Jewish (non-Israeli) I converted to Judaism None of the above

Have you or anyone in your family converted to Judaism? Please specify: Self Spouse Mother Father Children None

PLEASE NOTE: If you converted to Judaism in Israel, you MUST process your Aliyah at the Misrad Hapnim in Israel.

Have you ever been convicted of a felony? Yes No If yes, please explain:

Are you currently involved in any legal proceedings? Yes No If yes, please explain:

List any stressful events you have experienced over the past two years:

Note: This will not affect eligibility for acceptance to NBN, but will allow us to guide you more concretely through your Aliyah. Are you or any members of your immediate family listed on this application currently taking medications? Yes No

Please list all medications:

Please state the main reasons why you would like to make Aliyah: (Use back of this page if you need more room)

Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 5 Financial AffidavitAny information provided in this application is strictly confidential and will not be used for any reason other than determining eligibility for Nefesh B’Nefesh grants and services, or as required by law. 4 The amounts listed below should be in Pounds Sterling.

Primary Applicant’s full name(s) Please print LIABILITIES Current Secondary Applicant’s full name(s) Please print 19. Loans Payable to Banks and Others £ CURRENT INCOME 20. Credit Card Balance £ 1. Total Gross Earned Income - Primary Monthly Annual £ 21. Other Loans £ 2. Total Gross Earned Income - Secondary Monthly Annual £ Details 3. Net Investment Income £ Long Term ASSETS 22. Car Loan: Total Owed £ 4. Current Bank Accounts £ 23. Student and Bank Loans: Total Owed £ 5. Savings Accounts £ 24. Unpaid Taxes £ 6. Cash and Short Term Investments £ 25. Other Liabilities £ 7. Stocks, Options, Commodity Contracts £ Details 8. Value of Vehicles Owned £ 9. Retirement Funds/Pension £ 26. Mortgage on Property: Total Owed £ 10. Loans to Others and Accounts Receivable £ 11. Value of Interest in Any Business £ B. Total Liabilities £ Figure should be the total of line items 19 - 26 12. Do you have assets of any kind held in trust for you or any member of your immediate family? Yes No £ If yes, what is the value of the trust? NET WORTH What are the conditions for accessing that trust? Total Assets (A) £ Total Liabilities (B) (MINUS) - £ 13. Do you receive any financial assistance from any (EQUALS) = person or organisation (including family)? Yes No Your Net Worth £ Sources If yes, how much? £ Will this assistance continue after you make Aliyah? Yes No DECLARATION 14. Other sources of income: e.g. tax shelter investments, I hereby certify that the information provided in this collections, judgements, alimony, patents, social security. application is true and complete to the best of my knowledge and Specify type: belief and that I will notify Nefesh B’Nefesh of any changes in the Annual Income Received £ information. I hereby authorise Nefesh B’Nefesh to review and audit any and all of my financial records related to this affidavit Property (in the U.K. or abroad) and I hereby agree to provide any additional authorisations as 15. Principal Residence - Location required by the relevant financial institutions. Market Value £ I understand that if any of the information provided in this 16. Other Real Estate - Location affidavit is wilfully false or incomplete, or if Nefesh B’Nefesh Market Value £ discovers any discrepancy between my financial records and the 17. Are you renting out property? Yes No information provided in this affidavit, it will constitute a breach If so, what is your rental income? Monthly Annual £ of my grant and/or services agreement with Nefesh B’Nefesh. Will this annual income continue once in Israel? Yes No Primary Applicant Signature Date 18. When making Aliyah, do you plan to sell or rent out your current home? Rent Sell Secondary Applicant Signature (if applicable) Date A. Total Assets £ Applicant(s) signature required to process application. Figure should be the total of line items 4-8, 11, and 13-17 Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 6 References Please provide us with the names and contact information of people (non-relatives), either in North America, the United 5Kingdom or in Israel, who have known you for more than two years and who we can call upon as references for you. Reference (Israel): Name Address Phone number Reference Description

Reference (UK): Name Address Phone number Reference Description

If you are retired and have children in Israel, please list:

Name Address Phone number

6Signature I/We hereby certify that all answers which I/We have provided in this application are truthful and correct.

Primary Applicant Signature Date

Secondary Applicant Complete this checklist before Signature Date submitting your application Original application, including copies of requested documents Application fee

Financial Affidavit (incl. your printed name, your signature) Copy of each applicant’s birth certificate (with parent’s names listed) Post your completed application to: Copy of a letter from your rabbi, or Nefesh B'Nefesh conversion certificate, as applicable Attn: Guided Aliyah Department Two official, identical passport photos of each applicant age 16 and over (please write Beit Ofer name of applicant on back of each photo) 5 Nachum Hefzadi Photo of all family members making Aliyah Jerusalem, 95484 One photocopy of each applicant's passport

Copy of certificate of civil marriage, divorce, or death, apostille certification, as applicable Parents' names and dates of birth (p. 1) Completed Misrad Hapnim material Letter of Good Standing (or declaration from a lawyer)

Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 7 Disclaimer

I, the undersigned, ______, of ______, (insert address), have read the following statement and understood it, and do hereby agree to its terms and conditions.

I understand that Nefesh B’Nefesh is a non-profit organisation whose purpose is to aid and assist new immigrants who require information and assistance regarding various questions concerning their absorption in Israel.

I understand and agree that I have not, and shall not have, at any time in the future, any claims of any kind against Nefesh B’Nefesh and/or its employees individually and/or collectively, who do not and shall not bear any liability, whatsoever, for any act or omission in relation to any advice given to me or any counselling services, and/or personal accompaniment which Nefesh B’Nefesh or its employees shall provide; or any advice of a general nature which Nefesh B’Nefesh or its employees shall provide me.

For the sake of clarity, I hereby declare that I know that Nefesh B’Nefesh gives only primary advice, since they are not lawyers, custom agents or governmental officers. I am aware that for further advice I will need to consult with the relevant governmental agencies or with experts in the field. Any advice or services that Nefesh B’Nefesh may provide me are at my own risk, and I hereby irrevocably relinquish any claim which I may have, or will have, at any time, in relation to any of the above. I further declare that Nefesh B’Nefesh (in partnership with the Jewish Agency) is the sole organisation providing me with pre-Aliyah support services.

For the purpose of assisting in my Aliyah, I understand that some of the information I have relinquished to Nefesh B’Nefesh may be shared with the Jewish Agency for Israel and the Government of the State of Israel.

As an applicant to a programme receiving funding from the State of Israel, I the applicant am legally entitled to appeal to the State (to the appeals committee, the Vaad HaCharigim) to address any dispute I may have related to the award of a financial grant provided pursuant to the program’s implementation. To submit an appeal, I can send a sealed letter labeled “FOR VAAD HACHARIGIM” to the NBN Israel office (Beit Ofer - 5 Nachum Hefzadi Street, Givat Shaul, Jerusalem, 95484).

I have read and understood all of the contents of this disclaimer, and hereby agree to all of its terms and conditions. My agreement also represents the agreement to the above of all family members in this application. I hereby certify that all answers which I have provided in this application are truthful and correct.

Signed: ______Name: ______Date: ______

Photo Release Photos of individuals making Aliyah sponsored by Nefesh B'Nefesh will facilitate our work and continued efforts of increasing Aliyah from North America. We thank you for your cooperation.

I, the undersigned, ______, of ______(insert address), hereby give permission for Nefesh B'Nefesh to release photographs or videos of myself or my family in promotional or press related literature.

Signed: ______Name: ______Date: ______

Nefesh B'Nefesh - Financial Aid & Aliyah Services Application - Guided Aliyah Program 8 מדינת ישראל - משרד הפנים State of Israel - Ministry of the Interior

Application for New Immigrant/Oleh Status מדינת ישראל - משרד הפנים State of Israel - Ministry of the Interior

STATE OF ISRAEL – MINISTRY OF INTERIORDECLARATION FOR RECEIVING TEUDAT OLEH (OLEH VISA)

Last Name: ______First Name: ______Father’s Name: ______Country of Birth: ______Date of Birth (d/m/year): ______Nationality: ______Passport number: ______

I hereby declare that I have not suffered in the past, or am currently suffering from one of the following illnesses:

1. Mental Illness 2. Drugs or Alcohol addiction 3. Tuberculosis 4. Any other illness which might endanger public health.

I hereby declare that the details above are correct and were given with the knowledge that they are to serve as a basis for the consideration of my application.

I am aware that if I declare false information for receiving my Teudat Oleh, then the Minister of Interior has the authority to cancel my permanent resident license or my Teudat Oleh, according to paragraph 11 in the Law of Entry into Israel - 1952. Cancellation of my Teudat Oleh can result in the cancellation of my Israeli citizenship.

Signature: ______

For the use of the Ministry of Health Staff

I hereby confirm that this declaration was signed before me on ______(date) after being approved for aliyah.

Name of Dr. ______(signature) מדינת ישראל - משרד הפנים State of Israel - Ministry of the Interior Population Authority

Declaration of Religious and National Registration Details According to article 4b of the Law of Return

To The Regional Bureau for the Population Authority in Jerusalem

Completion of Religious and National Registration Details in the Population Registry

______FULL NAME IDENTIFICATION NUMBER

I hereby attest that I am a Jew according to article 4b of the Law of Return and request to register in the detail of the Religion “Jewish” and the Nationality “Jewish” of the Population Registry - my mother is Jewish / I converted* and I am not a member of any other religion.

______PLACE DATE SIGNATURE OF DECLARER

______THE ABOVE WAS SIGNED DATE SIGNATURE OF CLERK IN THE PRESENCE OF מדינת ישראל - משרד הפנים State of Israel - Ministry of the Interior Declaration (This declaration has to be attached to the form requesting change of status)

I, ______the undersigned declare that I have been made fully aware that I am entitled to be in Israel on any of the following visas:

1. On an Immigration Visa (Oleh), by the Law of Return, if I intend to settle permanently in Israel. 2. Or on a Student Visa (A-2), if I intend to come to Israel for the purpose of study only. 3. Or on a Tourist Visa (B-2), if at the present time I do not plan to settle in Israel. 4. Or on a Temporary Resident Visa (A-1), if I intend to explore the possibilities of set- tling in Israel within a period of three years.

Please circle the appropriate option:

I declare that:

1. I have never in the past resided in Israel as an immigrant or as a Temporary Resident (A-1).

2. I have resided in Israel from ______on a ______visa. My identity number was/is ______.

3. My husband/wife resided in Israel from ______on a ______visa. His/here identity number was/is ______.

Signature: ______Date: ______

I hereby confirm that this declaration was signed before me after its contents were read and further reviewed and clarified by me.

Name of the recipient of the statement: ______

Signature: ______Date: ______

This form must be completed for each family member making Aliyah

          

        ______'  , /  : :    / ,   /     

   

       

       

     

    "  

______      

______

______:

______

. .       

. .       

______  Name

______



 ______/  / ______      / ,   /     ,   /  ,/ . .  / " / 

______ 