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Page 1

JDC Entwine KAHAL Global Campus

Trip Location: Rome, Italy

Trip Dates: November 21, 2024 - November 24, 2024

Cost:

Standard Fee: $75
Early Bird Discount: $50 (for applications completed by October 16)

Register by October 16 to take advantage of the early bird discount and pay only $50! After October 16, the price increases!

The participation fee for the program includes all accommodation, meals, and activities. Transportation to and from the weekend is not included.

Global Campus is an immersive Shabbat experience for Jewish study abroad students to connect to a cohort of peers, local Jewish communities, and the values of Global Jewish responsibility.

At Entwine, we seek to represent, celebrate, and elevate the diversity of the Jewish community in our programs. We recognize that it is not possible for a form to capture all of who you are and what you represent. This will help us get to know you and gather the information needed for the program! Once you fill out this form, JDC Entwine staff will be in touch to schedule a 10-15 minute phone call and confirm your participation.

Should you have any issues completing this application, please contact: Raya Benus

This form should take approx 30 minutes-1 hour to complete.

Contact Information

First Name

Last Name

Preferred Name or Nickname

This way we can address you respectfully in conversation and communication.

Please select your pronouns (select all that apply)

Please describe your pronouns

Date of Birth

Global Campus is geared towards young adults in their early 20’s studying abroad

Address

Please follow the below conventions to make sure your address is submitted properly.

If you are in a dorm, please input your street address in Line 1, and building information (name and unit number) in Line 2; example below:

1600 Campus Rd (Line 1)
Stewie Hall, #2 (Line 2)
Los Angeles, CA 90041

Street Address (Line 1)

Physical street address (incl. address of Post Office if PO box)

Street Address (Line 2)

Apt #/PO Box #/Building name and #

City

Postal Code

Country

State

Province

Email (Personal)

Phone Number (Mobile)

Instagram

We love social media! Please add your Instagram handle.

Have you participated in a JDC Entwine KAHAL Global Campus before?

How did you learn about this program?

If Other, Please Share

Please share the name of the individual or organization

Study Abroad City

Study Abroad Country

Home University (if not listed, select Other)

Home University (if not listed above)

Graduation Year

Page 2

About You

Share a one paragraph bio about yourself written in the third person. Include information about your background, education, study abroad experience, volunteer activities, and hobbies. Note any past involvements with Entwine, if applicable. (150 word max)

If you are selected to participate on a trip, this bio will be shared with the group

What motivated you to study abroad? How are you hoping it broadens your perspective on the world? (150 word max)

Describe a travel experience that had an impact on you. (This could be individual or group travel, domestic or international, recent or in the past) (150 word max)

Past Participant Questions

Why would you like to participate in another KAHAL Global Campus Shabbat Experience while you are abroad this semester? (150 word max)

Page 5

Accommodations

Entwine strives to create an inclusive environment for all of our participants. Indicating the details below will ensure that you are best supported by our staff and that we can have open conversations about what support looks like in a given trip location. This in no way impacts your ability to participate, rather it helps us to better understand your needs as we prepare for the trip.

What accommodations, if any, do you need to ensure the Insider Trip environment supports your abilities? For example, a sign language interpreter; wheelchair accessibility

If not applicable, write N/A

Please indicate any dietary needs (kosher, vegetarian, etc.)

If not applicable, write N/A

We would also love to know any dietary preferences you may have - any things you might not like to eat, would rather not eat, or prefer to eat. We want to make sure the meals on the trip are to your liking, and will be in touch with any clarifying questions.

If not applicable, write N/A

Please indicate any allergies and the severity of each allergy.

If not applicable, write N/A

Please indicate your Shabbat observances, if any (electricity use, writing, attend Shabbat services, taking a bus, etc.)

Rooms on the trip will be double occupancy. We will try our best to honor your roommate request. If you do not request a roommate, JDC will pair you up with one.

Single rooms may be available for a supplemental fee of $250.00. If you would like to be placed in a single room, please contact Raya Benus.

Roommate Request

I would like to request a single room for a supplemental fee of $250.00

YesNo

Is there anything else you would like to share about rooming preferences?

Refer a friend!

Do you have a friend you think would want to join this program? Share their name:

Share their email:

Emergency Contact

Please identify an individual that should be contacted in case of emergency.

First Name

Last Name

Relation

Cell Phone

Email Address

Home Phone

Work Phone

Page 6

Program Liability Release & Pre-Trip Advisory

By checking the box and signing my name below, I hearby certify that I have read, understood, and agree to be bound by the terms, policies, and all rules and regulations of the Entwine Liability Release and Pre-Trip Advisory, including the medical clearance and COVID-19 Assumption of Risks.

I have read the Program Liability Release & Pre-Trip Advisory and agree to the terms, including the medical clearance and COVID-19 assumption of risk.

Yes

Terms for Enrollment

Entwine is committed to upholding its values to honor the dignity and promote the safety of all people. We recognize that no community, including our own, is immune from bias and misconduct, and have a Community Code that applies our values into actions. I understand that by applying to this program I am agreeing to uphold the items outlined in the Community Code.

I understand that, as a condition of program participation, I will be required to sign a JDC general liability release and pre-trip advisory, which includes the medical clearance, COVID-19 parameters, that I hold a valid passport, and emergency contact information.

I understand that my application and participation information will be shared with JDC Entwine

I understand that, as a condition of program participation, I will be required to participate in all organized activities during the program.

I understand that, as a condition of program participation, I will be expected to participate in post-trip follow up including a survey.

I understand that I will be traveling with the American Jewish Joint Distribution Committee (JDC) and that I will be experiencing communities and needs overseas through JDC's unique lens and role in the country of service/study.

I understand that the trip I am applying for is pre-subsidized and that Entwine cannot offer any additional subsidies.

By typing my name below, I hereby certify that all above statements are true to the best of my knowledge.

Today's Date

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Prefer not to answer	Ashkenazi	Bukharian
Conservative	Culturally Jewish	Ethiopian
Hasidic	Indian	Interfaith/multifaith
Jew by Choice	Jewtina/o	Mizrahi
Modern Orthodox	Multiethnic or multiheritage	Nondenominational
Not Jewish	Orthodox	Persian
Pluralistic	Reconstructionist	Reform
Renewal	Russian Speaking Jew (RSJ)	Secular
Sephardi	Spiritual	Traditional
Prefer to self-identify

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JDC Entwine KAHAL Global Campus

Should you have any issues completing this application, please contact: Raya Benus

This form should take approx 30 minutes-1 hour to complete.

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JDC Entwine KAHAL Global Campus

Should you have any issues completing this application, please contact: Raya BenusThis form should take approx 30 minutes-1 hour to complete.

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Should you have any issues completing this application, please contact: Raya Benus

This form should take approx 30 minutes-1 hour to complete.