Club Z Application Bay Area *RequiredFirst Name *Last Name *Male/Female MaleFemaleGrade In The Fall of 2020 *89101112otherPhone *Email *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryDate of Birth *Which School Do You Attend *What is the best way to communicate with you? *TextWhatsAppEmailPhoneSnapchatFacebookDo You Keep Shabbat? *YesNoMaybeDo you have any physical limitations? *Shirt Size (adult sizes) SmallMediumLargeXLXXLXXXLOtherAny Special Talents You'd like to share with the group? *Why do you want to join Club Z? *(250-word limit)Why is Israel important to you? *(250-word limit)What makes you a strong leader? *(250-word limit)Do you agree to schedule an interview and/or attend one of our recruitment events? *YesYour Commitment: To Be Admitted to Club Z Institute means you are making a commitment to attend all required events and meetings, retreats and national conference *YesGuardian InformationParent 1 First Name *Parent 1 Last Name *Parent 1 Phone Number *Parent 1 Email Address *Parent 2 First Name Parent 2 Last Name Parent 2 Phone Number Parent 2 Email Address Dates Pricing Breakdown for Mandatory Club Z Activities: Sept 4-7th Retreat Price:$300 Institute Dates: $325 January 17th-20th National Conference: Payment will be submitted at a later date. Fees are not refundable. Palo Alto or East Bay Palo AltoEast BayInstructions Important Information After submitting your application below, you will be directed to a page with payment information. Your application is not complete until the payment has been submitted. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
