If you are interested in taking part in new voluntary service program, we
would kindly ask you to fill in the following assignment form.

Full name:

Date of birth:

Place of birth:

Passport number:

Valid until:

Full address in Israel:

Telephone number:

Email address:

Marital status:

Education history:

Employment history:

Language ability:

Personal interests:

Preferred working field:
child careeducation, youth workreligious workelderly care, nursing serviceanimal care, environmental carecultural workno preferred working fieldother:


350 Words on personal background and motivation to volunteer in Germany:

Some thoughts and expectations on your stay in Germany: