Gift Of Israel Application Student Application Date First Name Middle Name Last Name Gender Male Female Other SSN Phone 1 Phone 2 Parent/Guardian 1 Full Name Parent/Guardian 2 Full Name Synagogue/Religious School (If Applicable) Select Synagogue/Religious School #N/A #N/A Attending Jewish Day School #Other Agudath B'nai Israel Ahavas Yisrael Aish HaTorah Am Shalom of Lake County Anshe Chesed-Fairmount Temple Ashkenas B'nai Jeshurun Congregation B'nai Torah Congregation Bais Avrohom Beachwood – University Heights Kollel Beachwood Kehilla Beis Doniel Beth El-Heights Synagogue Beth Israel - The West Temple Cedar Sinai Synagogue Chabad of Beachwood Chabad of Cleveland Cleveland Hebrew School Cleveland Torah Center Congregation Beis Doniel Congregation Shaarey Tikvah Congregation Tiferes Avigdor Froimovitz Chabad Green Road Synagogue Heights Jewish Center Jewish Education Center Jewish Family Experience Jewish Learning Connection K'hal Yereim Kehillas Bnai Torah Kol Chadash Kol HaLev-Reconstructionist Havurah Kollel Yad Chaim Mordechai Oheb Zedek Cedar Sinai Synagogue Ohel Sarah Park Synagogue Semach Sedek Shomre Shabbos Solon Chabad Suburban Temple-Kol Ami Taylor Road Synagogue Telshe Yeshiva Temple B'nai Abraham Temple Emanu El Temple Israel Ner Tamid The Aleksander Shul The Niggun Minyan The Sephardic Congregation of Cleveland The Shul The Temple-Tifereth Israel Torah L.I.F.E. Institute Torah U'tefilah Unaffiliated Warrensville Center Synagogue Waxman Chabad Center Young Israel of Greater Cleveland Zecher Asher Zelig Zichron Chaim Other Synagogue/Religious School * Date of Birth Secular School (If Applicable) Congregation Select Congregation #N/A #N/A Attending Jewish Day School #Other Agudath B'nai Israel Ahavas Yisrael Aish HaTorah Am Shalom of Lake County Anshe Chesed-Fairmount Temple Ashkenas B'nai Jeshurun Congregation B'nai Torah Congregation Bais Avrohom Beachwood – University Heights Kollel Beachwood Kehilla Beis Doniel Beth El-Heights Synagogue Beth Israel - The West Temple Cedar Sinai Synagogue Chabad of Beachwood Chabad of Cleveland Cleveland Hebrew School Cleveland Torah Center Congregation Beis Doniel Congregation Shaarey Tikvah Congregation Tiferes Avigdor Froimovitz Chabad Green Road Synagogue Heights Jewish Center Jewish Education Center Jewish Family Experience Jewish Learning Connection K'hal Yereim Kehillas Bnai Torah Kol Chadash Kol HaLev-Reconstructionist Havurah Kollel Yad Chaim Mordechai Oheb Zedek Cedar Sinai Synagogue Ohel Sarah Park Synagogue Semach Sedek Shomre Shabbos Solon Chabad Suburban Temple-Kol Ami Taylor Road Synagogue Telshe Yeshiva Temple B'nai Abraham Temple Emanu El Temple Israel Ner Tamid The Aleksander Shul The Niggun Minyan The Sephardic Congregation of Cleveland The Shul The Temple-Tifereth Israel Torah L.I.F.E. Institute Torah U'tefilah Unaffiliated Warrensville Center Synagogue Waxman Chabad Center Young Israel of Greater Cleveland Zecher Asher Zelig Zichron Chaim Highschool Graduation Year Select Graduation Year 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 Address City State Select State # N/A Alabama Alaska Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Island Virginia Washington West Virginia Wisconsin Wyoming Zip Code Current Grade Select Current Grade Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Jewish Day School (If Applicable) Select Jewish Day School #N/A Attending Supplemental Religious Education Chaviva High School - 0 Fuchs Mizrachi School - 20 Gross Schechter Day School - 14 HAC - 0 HAC Boys grades 7-8 - 0 HAC Elem. Gen. Studies - 0 HAC Judaic - 0 HAC Yavne - 0 HAC YOC Boys grades 9-12 - 0 Hebrew Academy of Cleveland - 2 JEC SEGULA - 0 Mandel JDS (Agnon School) - 4 Telshe Yeshiva - 0 YDT - 19 YDT Elementary Boys - 0 YDT Elementary Girls - 0 YDT High School Girls - 0 Yeshiva High School of Cleveland [Fairmont] - 0 Yeshiva of Cleveland [Oakwood] Chofetz Chaim - 0 How would you describe yourself? Select Denomination #N/A Conservative Jewish/Non-Denominational Orthodox Other Reconstructionist Reform Other Denomination Custodian Full Name Email Maiden Name of Custodian's Mother Driver License Number Driver License Issue Date Driver License Expire Date Driver License State Select License State # N/A Alabama Alaska Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Island Virginia Washington West Virginia Wisconsin Wyoming Employer Occupation SSN Date of Birth Custodian Address Same as Student Address City State Select State # N/A Alabama Alaska Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Island Virginia Washington West Virginia Wisconsin Wyoming Zip Code Custodian Phone Number Credit Card Information Credit Card Type Select Card Type American Express Discover Master Card Visa Credit Card Provider Expiration Date Last 4 Digits Submit Application A GIFT OF ISRAEL, administered by the Jewish Education Center of Cleveland, is supported by the Fund for the Jewish Future of the Jewish Federation of Cleveland.