JFS Fall 2019 Application Step 1 of 5 - Basic Information 20% Select the programs for which you would like to apply JFS Tour (Oct 21 - Nov 2) - 2850 USD Dig at Et Tell Week 1 (Nov 2 - 9) - 950 USD Dig at Et Tell Week 2 (Nov 9 - 16) - 950 USD JFS Tour - Fall 2019 Price: $2,850.00 Et Tell Excavation Week 1 (Nov 2 - 9) Price: $950.00 Et Tell Excavation Week 2 - (Nov 9 - 16) Price: $950.00 Total $0.00 * You will receive payment information upon acceptance of application Save and Continue Later Personal DetailsName* First Last Date of Birth* Date Format: MM slash DD slash YYYY Country of Citizenship*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*Email* Please upload a passport style photograph Save and Continue Later Academic InformationName of academic institution currently attending or last attended (Name, State, Country)*Year Completed Date Format: MM slash DD slash YYYY Please leave blank if still enrolledCourse of Studies*Please briefly describe area of study, number of credits, or degree earned.Other institutions?YesNoAcademic Institution #2Name of Academic Institution*Year Completed Date Format: MM slash DD slash YYYY Please leave blank if still enrolledCourse of Study*Please briefly describe area of study, number of credits, or degree earned.Other Institutions?YesNoAcademic Institution #3Name of Academic Institution*Year Completed Date Format: MM slash DD slash YYYY Please leave blank if still enrolled.Course of Study*Please briefly describe area of study, number of credits, or degree earned. Save and Continue Later Please identify any pre-existing medical conditions. Allergies Inflammatory Disease Amoebic Dysentery Asthma Diabetes Epilepsy Foot or Leg Conditions Gastro-Intestinal Disease Hepatitus High Blood Pressure HIV/AIDS Hypertension Hypoglycemia Kidney Condition Learning Disability Malaria Mental Health / Disorder Migraine Headaches Mononucleosis Nervous Disorder Paralysis Pneumonia Rheumatic Fever Substance Abuse Tuberculosis Have you ever been under the care of a mental health physician?* Yes No Please explain.Are you receiving medication or physician's care for any medical conditions?* Yes No Please explain.Do you have any previous history of substance abuse or mental illness?* Yes No Please explain.Are you allergic to any medication or foods?* Yes No Please explain.Do you have any dietary restrictions?* Yes No Please explain.Are there any other medical conditions or information that we should know about you?* Yes No Please explain.In Case of Emergency* I give permission to a JFS representative in Israel to select a physician, to hospitalize, to secure proper treatment, to order injections, anasthesia, or surgery for me. Save and Continue Later Liability Waver* I agree.On my behalf and on behalf of my heirs, executors, personal representatives, contractees and employees, I hereby release and forever discharge Jerusalem Field School, their officers and employees from any claim for loss, death, disability, delay, or damage to person, property, or for accident or illness howsoever arising which may be suffered by me or by anyone claiming though me, during the period of, in consequence of, or in any way related to the work and/or study undertaken by me in connection with my participation in this Project.Standard of Conduct* I agree.The undersigned acknowledges the right of the Jerusalem Field School (JFS) to remove anyone from the program. JFS does not assume any financial obligation to refund the cost of the program or any expenses associated with travel or lodging because of an early dismissal. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.