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Aliyah Services Application Place photo here Units: Date Received: For Internal Use Only GASO_ 041116 Name of Applicant Last Name, First Name City of Residence City City of Origin City, State/Province Email Address Guided Aliyah Preferred Aliyah Month: Month Year

Guided AliyahEligibility 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

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Page 1: Guided AliyahEligibility 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

Aliyah Services Application

Place photo here

Units:

Date Received:

For Internal Use Only

G A S O _ 0 4 1 1 1 6

Name of Applicant Last Name, First Name

City of Residence City

City of Origin City, State/Province

Email Address

Guided AliyahPreferred Aliyah Month:

Month Year

Page 2: Guided AliyahEligibility 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

Nefesh B'Nefesh ServicesNefesh 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 AidThe financial commitment of pilot trips, securing a home, acquiring and shipping household appliances and furnishings can be challenging. To obviate these fiscal obstacles, Nefesh B'Nefesh provides financial assistance to eligible individuals and families to enable them to make their dream of Aliyah a reality.

Pre-AliyahOur Pre-Aliyah Department assists Olim in all areas of their Aliyah planning. Our expert Pre-Aliyah staff answer all questions regarding the Aliyah process. This department is also responsible for grant allocations and for overseeing the application review process.

EmploymentOur Employment Department helps Olim who are seeking assistance in finding employment, job retraining, career development, or professional mentoring.

Absorption - KlitaOur Absorption Department is ready to assist Olim with questions regarding Oleh benefits, government processing, or any other aspect of their absorption. The answers to many frequently asked questions about Aliyah and benefits can be found on our website (see below).

Guidance and Community ResourcesOur Guidance and Community Resources Department provides guidance or referrals in matters of education, community, summer programs, ulpanim and physical or mental health. It also assigns buddy families to help Olim in the inital stages of their klita.

Online ResourcesNBN Website: We are constantly updating our website with Aliyah resources, contacts and useful information and links. Find us at www.nbn.org.il

NBN Yahoo Group: We have set up a Yahoo discussion group for our applicants and veteran Olim for exchanging advice, contacts and community information. To sign up, email: [email protected]

NBN Singles Yahoo Group: There is a unique Yahoo group specifically for Single Olim: To sign up, email: [email protected]

Page 3: Guided AliyahEligibility 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

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 States or Canada and hold valid passports from one of these two countries.

If you have: • Converted to Judaism in Israel

• An Israeli passport or were born abroad to an Israeli parent

• A birth certificate from the former Soviet Union or Eastern Bloc

• Renounced Israeli citizenship at any time in the past

• Previously been convicted of a crime

Misrad Hapnim guidelines dictate that you CANNOT be 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.

If you converted to Judaism in North America: Misrad Hapnim policy requires that you must reside in the community in which you converted for a period of at least one year before being eligible to make Aliyah.

If you are applying for Aliyah with a newborn child recently born in Israel (who was not registered as an Israeli citizen at the time of their birth) you will have to have a US, Canadian or UK passport issued for that child before submitting your application.

If your spouse is an Israeli citizen, and you have children born abroad, please contact our Absorption Department in order to clarify whether or not your children are considered Israeli citizens and to determine if they are eligible to participate in the Guided Aliyah program.

Page 4: Guided AliyahEligibility 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

Misrad Hapnim Material Please complete the enclosed material from Misrad Hapnim (Israeli Ministry of Interior). These forms MUST be filled out by all family members age 16 and over making Aliyah. Please photocopy this section as necessary. “Application for Oleh status” form needs to be filled out for each family member making Aliyah.

Photo Enclose a recent color photo of all individuals making Aliyah. Families: Enclose one picture which includes all family members together. Singles: Enclose a photo of the applicant only.

ApplicationPlease submit your original application and copies of all requested documents. Please retain an additional copy of all paperwork for yourself.

Application Fee Application must be accompanied by a check (made payable to Nefesh B’Nefesh) or cash payment in the amount of 100.00 NIS. Please Note: The application fee is non-refundable.

Birth CertificatesPlease 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 in English or Hebrew, please submit a notarized translation into English or Hebrew with a copy of the birth certificate.

Ce rtificate of Marital StatusPlease submit a copy of relevant documentation according to your marital status, i.e.: civil marriage certificate, divorce cer-tificate, or death certificate of spouse. All civil documenta-tion 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 notarized translation into English or Hebrew with a copy of the marital status certificate.

Teudat Yosher The Ministry of Interior requires that all Aliyah applicants age 16 and over obtain a Letter of Good Standing (Teudat Yosher) from the authorities in their country of origin (issued by the country/state/provincial police) certifying that the applicant has no criminal background. Apostille certification (also called a chain of signatures or legalisation) must be affixed to the original Letter of Good Standing. Guided Aliyah applicants who are unable to obtain this documentation may submit a declaration signed in the presence of an Israeli lawyer in lieu of the police record. Please find the declaration form attached to the back of this application.

Passport Photocopies Please submit a copy of the main page of your US or Canadian passport (the page which includes your picture) and that of everyone in the family who is making Aliyah. Please include photocopies of all pages indicating applicable date extensions, and/or name changes. Your passport must be valid for at least six months from your projected date of Aliyah.

Passport Photos Please include two official and identical passport photos of each family member age 16 and over who is making Aliyah. The photos should be in color, 35 mm wide by 45 mm high, front view, ears showing, and on a blue or white background. Please print the full name of each Oleh on the back of each photo.

Application Instructions continued on the next page

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.

45 mm

35 mm

Head dimensions25 mm wide35 mm high

[

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.

Page 5: Guided AliyahEligibility 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

Page4Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

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.

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 notarized translation if applicable)• Civil Marriage/Divorce/Death Certificate with

apostille certification (if applicable)• Proof of Judaism • Valid US or Canadian Passport• Letter of Good Standing (or declaration from a lawyer)• Notarized 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.

Important note: Please read!

Acceptable Proof of JudaismPlease submit a copy of one of the following:

1) Signed letter in English or Hebrew from a recognized Rabbi in North America on official synagogue letterhead, which states the following:• Name, location and telephone number of congregation• Applicant’s full name and parents’ names• Applicant (and spouse, if applicable) is Jewish and born to

a Jewish motherIf you are Jewish through your father/grandfather, please provide a letter from a recognized Rabbi in North America who can confirm your Jewish heritage.

2) Conversion Certificate from a recognized Beit Din (Rabbinical Court). The certificate must be signed by the three members of the officiating Beit Din.In addition to your conversion certificate, please submit two accompanying letters, as follows:

A) A letter from the rabbi with whom you studied in preparation for your conversion. The letter must appear on synagogue letterhead and describe the following:• Details of your conversion process• Where you studied (e.g. organization name)• Relevant dates• Community involvement• If you have children, indicate if they were born before

or after your conversion

B) Please submit a letter detailing your decision to convert to Judaism and your involvement in the Jewish community since the completion of your conversion process.

For Parents of Minor Children• If you are making Split Aliyah (where one spouse

makes Aliyah and one does not), Misrad Hapnim requires a notarized letter of consent from the par-ent who is NOT making Aliyah authorizing his or her spouse to make Aliyah with their children. Please submit a copy of this letter with your application.

• If you or your spouse has minor children from a previ-ous marriage, Misrad Hapnim requires a notarized letter of consent from the child’s other parent authoriz-ing you to make Aliyah (in addition to a copy of your divorce agreement/custody order). If the child in ques-tion is making Aliyah, the letter will need to state that the child is permitted to obtain Israeli citizenship. You will need this letter whether your children are making Aliyah with you or not. Please submit a copy of this letter with your application.

Page 6: Guided AliyahEligibility 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

1Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

1Applicant 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. Section A of this application should be filled out by the Primary Applicant and Section B by the Spouse.

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

Preferred First Name Occupation Gender Male Female

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?

If yes, please explain:

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

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

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

A: Primary Applicant Information

Home Phone Work Phone Mobile Phone Email Address

Current Address Street Address City Neighborhood Postal Code

Contact Information

Date you moved to Israel: MM/DD/YYYY

How long have you been living in Israel in the past seven years:

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

Mother's Name: Date of Birth: MM/DD/YYYY

Father’s Name: Date of Birth: DD/MM/YYYY

Have either of your parents made Aliyah? Mother Date MM/DD/YYYY

9-Digit Teudat Zehut No.

Father Date MM/DD/YYYY

9-Digit Teudat Zehut No.

Are either of your parents Israeli citizens? Father Mother Neither

Have you ever held an A1 Visa (Temporary Resident)? Yes No If yes, FROM MM/DD/YYYY

TO MM/DD/YYYY

If so, what is your 9-digit Israeli ID Number?

Date of Birth MM/DD/YYYY

Country of Birth If Israel, at what age did you leave Israel?

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

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

Marital StatusImportant: Please submit a photocopy of your civil marriage, divorce or spouse’s death certificate, if applicable.

Married Single DivorcedWidowed Separated Engaged Jewish Affiliation

Charedi Orthodox Masorti ReformLiberal Unaffiliated Other

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2Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

C: Children Please provide the information below, if applicable. Please enter full names, as they appear on your children’s passports.

Child 1 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Child 2 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Child 3 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Child 4 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Child 5 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Child 6 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Child 7 Last Name, First Name, Middle Name (as appears in passport) Gender DOB: MM/DD/YYYY Country of Birth Will this child be making Aliyah with you?

Male Female Yes No

Country of CitizenshipPlease list all countries to which you hold citizenship.

Date you moved to Israel: MM/DD/YYYY

How long have you been living in Israel in the past seven years:

Mother's Name: Date of Birth: MM/DD/YYYY

Father’s Name: Date of Birth: MM/DD/YYYY

Have either of your parents made Aliyah? Mother Date MM/DD/YYYY

9-Digit Teudat Zehut No.

Father Date MM/DD/YYYY

9-Digit Teudat Zehut No.

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) Last First Middle Maiden

Country of Birth If Israel, at what age did you leave Israel?

Preferred First Name Occupation Gender Male Female Date of Birth MM/DD/YYYY

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

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 MM/DD/YYYY

TO MM/DD/YYYY

If so, what is your 9-digit Israeli ID Number?

Name

List any Jewish groups, camps, and/or organizations 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.

A: Primary Applicant 2Personal 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.

Are either of your parents Israeli citizens? Father Mother Neither

Page 8: Guided AliyahEligibility 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

3Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

Education

High School Name of Institution City Location Years Attended Degrees Attained

e.g. 1987-1991

College/University Yeshiva Gedola/Seminary

Name of Institution City Location Years Attended Degrees Attained e.g. 1991-1995

Post-College/Kollel Name of Institution City Location Years Attended Degrees Attained

e.g. 1995-1999

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

Employment HistoryI am currently Employed Unemployed Studying Retired

Job 1 Company name Position Held Start Date End Date

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?

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

Please list your last two jobs, beginning with the most recent:

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 MM/DD/YYYY

TO MM/DD/YYYY

Are you planning to serve in the Israeli Defense Force after your Aliyah? Yes No

Were you born to a Jewish mother? Yes No

Jewish Lineage

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

NOTE: Please submit a copy of all conversion documents with application.

If so, please indicate the dates of conversion & to whom they apply: MM/DD/YYYY

If any of these conversions took place in Israel, please indicate which conversions:

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

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, in which state: Please explain:

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

What family do you have in Israel?

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

Page 9: Guided AliyahEligibility 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

4Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

B: Spouse - Complete only if spouse is making AliyahName

List any Jewish groups, camps, and/or organizations 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 MM/DD/YYYY

TO MM/DD/YYYY

Are you planning to serve in the Israeli Defense Force after your Aliyah? Yes No

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

Note: This will not affect eligibility for acceptance to NBN, but will allow us to guide you more concretely through your Aliyah.

Please list all medications:

Are you or any members of your immediate family listed on this application currently taking medications? Yes No

Employment HistoryI am currently Employed Unemployed Studying Retired

Job 1 Company name Position Held Start Date End Date

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?

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

Please list your last two jobs, beginning with the most recent:

Education

High School Name of Institution City Location Years Attended Degrees Attained

e.g. 1987-1991

College/University Yeshiva Gedola/Seminary

Name of Institution City Location Years Attended Degrees Attained e.g. 1991-1995

Post-College/Kollel Name of Institution City Location Years Attended Degrees Attained

e.g. 1995-1999

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

Page 10: Guided AliyahEligibility 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

5Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

Note: This will not affect eligibility for acceptance to NBN, but will allow us to guide you more concretely through your Aliyah.

Please list all medications:

Are you or any members of your immediate family listed on this application currently taking medications? Yes No

Have you ever been convicted of a felony? Yes No If yes, in which state: 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:

Were you born to a Jewish mother? Yes No

Jewish Lineage

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

NOTE: Please submit a copy of all conversion documents with application.

If so, please indicate the dates of conversion & to whom they apply: MM/DD/YYYY

If any of these conversions took place in Israel, please indicate which conversions:

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

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

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

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

Page 11: Guided AliyahEligibility 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

6Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

Complete this checklist before submitting your application

Original application, including copies of requested documents

Application fee

Copy of each applicant’s birth certificate (with parent’s names listed)

Copy of a letter from your rabbi, or conversion certificate, as applicable

Two official, identical passport photos of each applicant age 16 and over (please write name of applicant on back of each photo)

Photo of all family members making Aliyah

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)

Mail your completed application to:

Nefesh B'NefeshAttn: Guided Aliyah Department

Beit Ofer5 Nachum HefzadiJerusalem, 95484

4 Signature

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

Secondary Applicant Signature Date

Primary Applicant Signature Date

3 References Please provide us with the names and contact information of people (non-relatives), either in North America, the United Kingdom 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 (North America):

Name Address Phone number Reference Description

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

Name Address Phone number

Name Address Phone number

Page 12: Guided AliyahEligibility 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

7Nefesh B'Nefesh - Aliyah Services Application - Guided Aliyah Program

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 organization 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 counseling 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 organization 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.

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 ReleasePhotos 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: _____________

Page 13: Guided AliyahEligibility 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

מדינת ישראל - משרד הפניםState of Israel - Ministry of the Interior

Application forNew Immigrant/Oleh Status

Page 14: Guided AliyahEligibility 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

מדינת ישראל - משרד הפניםState of Israel - Ministry of the Interior

STATE OF ISRAEL – MINISTRY OF INTERIORDECLARATION FOR RECEIVINGTEUDAT 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 Illness2. Drugs or Alcohol addiction3. Tuberculosis4. 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)

Page 15: Guided AliyahEligibility 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

מדינת ישראל - משרד הפניםState of Israel - Ministry of the Interior

Population Authority

Declaration of Religious and National Registration DetailsAccording 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

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 amember of any other religion.

_______________________________SIGNATURE OF DECLARER

_______________________________DATE

_______________________________PLACE

_______________________________SIGNATURE OF CLERK

_______________________________DATE

_______________________________THE ABOVE WAS SIGNED

IN THE PRESENCE OF

_______________________________IDENTIFICATION NUMBER

_______________________________FULL NAME

Page 16: Guided AliyahEligibility 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

מדינת ישראל - משרד הפניםState 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: ___________________

Page 17: Guided AliyahEligibility 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
Page 18: Guided AliyahEligibility 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

This form must be completed for each family member making Aliyah

Page 19: Guided AliyahEligibility 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
Page 20: Guided AliyahEligibility 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

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