Register for Palestine Summer Encounter!

READ THIS FIRST! In order to apply for the Palestine Summer Encounter program you must complete the application form and submit your $150 registration fee. Click here for information on payment methods.

Applications will be accepted after the deadline on a case by case basis. A late application fee will also be charged. Click here for the dates and deadlines.

We STRONGLY prefer that you complete the application form online, but if a paper application form is the only way you can complete your application (because you do not have access to the internet, for example) then please contact us.

We estimate that the application form will take approximately 15 to 20 minutes to complete. Before you begin filling out the application form, please be sure you have enough time to complete the entire form (you will not be able to save your progress). Also be sure you have all of the following information readily available:

  • Info. on your previous work experience and schooling
  • Any special health concerns and special travel arrangements
  • Your passport information
  • Names and Contact info. for 2 professional references
  • Name and Contact Info. of an emergency contact

    Please understand that we need to collect a considerable amount of information in order to place you at an appropriate volunteer opportunity, look after your health and safety and place you at an appropriate level for your Arabic class. Giving full and honest questions to all required questions will help simplify this process.


  • Section I (of V)
    General Information

    General Information > Volunteer Assesment > Travel Arrangements > Arabic Proficiency > Liability Form > Confirmation

    * denotes a required field
     
    First Name *
    Middle Name
    Last Name *
    [Note: Please type your full name, above, exactly as it appears on your passport]

    Home Phone Number *
    Mobile Phone Number
    Work Phone Number
    E-mail Address *

    Mailing Address:

    Street Address *
    City *
    State (U.S. Only)
    Zip Code *
    Country *

     
    What is the best way to contact you? *


    Passport Information

    Citizenship
    Place of Passport Issue
    Passport Number
    Issue Date      
    Expiration Date      

     

    Date of Birth *      
    Gender *
    What is your ethnicity?
    What is your religion?
    How did you first hear about the trip?
    Would you like to receive our periodic mailings? *
    Would you like to receive our e-mail newsletter? *
    Emergency Contact Information *
    Do you have any allergies? *
    If so, please list:
    Are you a vegetarian? *
    Special Needs
    Have you traveled to the Middle East before?
    If so, where and why?
    Is there someone else participating in the program who you would like to be housed with? If so, write their name here:
    Are you married? *
    Is your spouse or partner also participating in this trip? *
    Do you have any children attending? *

    General Information > Volunteer Assesment > Travel Arrangements > Arabic Proficiency > Liability Form > Confirmation
     

    Check back soon for more info. on the 2009 summer program!