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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Date of Birth

Date

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* 5. What is your country of origin?

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* 6. What country do you reside in?

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* 7. What is the name of your high school/secondary school?

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* 8. In what city is your school?

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* 9. What year are you in school?

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* 10. This year’s Jewish Youth Assembly operates in English. Do you feel comfortable speaking, reading, and writing in English, as well as understanding spoken English?

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* 11. What does your Jewish identity mean to you?

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* 12. What is the biggest issue facing your Jewish community?

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* 13. Why are you applying to participate in the Jewish Youth Assembly?

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* 14. Please rank the 8 focus areas of the World Jewish Congress in order of which you place importance of them.

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* 15. Please explain why you chose your first choice focus area as most important to you:

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* 16. How did you hear about the Jewish Youth Assembly?

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