March of the Living South Africa
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March of the Living
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Apply
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Youth Delegation
Programme Info
Visa & Travel Info
Apply
Testimonials
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Gallery
Home
About
March of the Living
The Team
Adult Delegation
Programme Info
Young Adult
Visa & Travel Info
Apply
Gallery
Youth Delegation
Programme Info
Visa & Travel Info
Apply
Testimonials
Blog
Gallery
March of the Living Youth Delegation Application Form
Please complete the application form below.
Note: partial forms cannot be saved
.
It is recommended for applicants to prepare their motivational answers in a word document beforehand, so that they can be easily copy-pasted to the form.
1. Applicant Information
*
Indicates required field
Full Name (As Shown on Passport)
*
Email (Important - all communications will be sent here!)
*
Gender
*
Female
Male
Physical Address
*
Postal Address
*
High School
*
Additional Emails (Optional)
*
Phone Number of Applicant (Cell)
*
3. Passport Information
Nationality
*
Passport 1
Date of Birth (DD/MM/YY)
*
2. Emergency Contact
Name
*
Passport Number
*
Expiry Date (DD/MM/YY)
*
Passport Country of Issuance
*
Relationship to Applicant
*
Contact Number
*
4. Health History
Are you generally in good health? (If no, please elaborate)
*
Are you taking any medication?
*
Do you suffer from any allergies?
*
Passport 2 (if applicable)
Describe any physical handicaps, restrictions or disabilities you may have
*
Do you need to apply for a Schengen visa?
*
Have you ever been in any kind of therapy (physical, psychological, social or other) ?
If so, please indicate below. All information will be kept strictly confidential.
Name of person consulted
*
Profession
*
Dates of Consultation
*
Reason for therapy
*
Have you suffered a significant loss? Please describe.
*
5. Personal Profile
Are any of your family survivors of the Holocaust? If yes, please list:
*
Did any of your relatives perish in the Holocaust? If yes, please list:
*
Why do you want to participate on the March of the Living? (please provide as detailed a response as possible):
*
What do you think you can contribute to the programme and the group?
*
Do you require financial assistance for the programme? (*Please note that we have limited subsidy packages available based on need)
*
Yes
No
Additional Passports Information
*
This programme necessitates participants with a high sense of maturity and sensitivity. Please indicate that you understand that rooming assignments will be allocated at the staff's discretion:
*
Yes
No
Submit