Short Term Program Application Form

1Applicant Information

2Passport/Visa Information

3Translation Background & Activities

4Educational Background

5Additional Instructions

Instruction: Please copy all information directly from the passport or other official document.
Name as it appears in the passport*
Passport number*
Place of Issue*
Date of Expiration*
Father's First Name*
Religion*
Mother's First Name*
Previous Last Name (if any)
Previous Stays in Israel
Dates Passport Number
Date of Intended Arrival in Israel*
DD slash MM slash YYYY
Date of Intended Departure from Israel*
DD slash MM slash YYYY
Indicate which Israel Embassy is most convenient to pick up your visa (city)*

Decide carefully as this information is critical. The visa will be sent to this location ONLY.

Target Translation Language*
Size of Language Group*
Do you have one year of Biblical Hebrew studies or equivalent?*
- Yes
- No
Please describe your past, present, and projected activities in relation to Bible translation work and the potential benefits from this course.*

Undergraduate Studies
Name of Institution, City, State/Province, Country*
Major Field of Study*
Number of Years Studied*
Degree/Certificate received*
Date*
DD slash MM slash YYYY
Graduate Studies 1
Name of Institution, City, State/Province, Country*
Major Field of Study*
Number of Years Studied*
Degree/Certificate received*
Date*
DD slash MM slash YYYY
Graduate Studies 2
Name of Institution, City, State/Province, Country*
Major Field of Study*
Number of Years Studied*
Degree/Certificate received*
Date*
DD slash MM slash YYYY
Graduate Studies 3
Name of Institution, City, State/Province, Country*
Major Field of Study*
Number of Years Studied*
Degree/Certificate received*
Date*
DD slash MM slash YYYY

The following items are required with this application form.
Page of past, present, and future activities*
Max. file size: 64 MB.
One digital photo of applicant, of standard passport size and dimensions*
Max. file size: 64 MB.
Scan of passport picture page*
Max. file size: 64 MB.
Scan of marriage certificate
Max. file size: 64 MB.
#1 Academic or professional recommendation letter, written by someone with whom you have had an academic or professional connection*
Max. file size: 64 MB.
#2 Academic or professional recommendation letter, written by someone with whom you have had an academic or professional connection*
Max. file size: 64 MB.
I agree to be subscribed to JCBT’s English newsletters*
- Yes, please.
- No, thank you.
JCBT MEDIA RELEASE*
- I agree to the JCBT Media Release
- I do not agree to the JCBT Media Release
I, the undersigned, do hereby consent and agree that Jerusalem Center for Bible Translators, its employees, or agents have the right to take photographs and video and to use these in any and all media, now or hereafter known, and exclusively for the purpose of advertising. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to Jerusalem Center for Bible Translators, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that Jerusalem Center for Bible Translators is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result. I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.
Signature*
Date*
MM slash DD slash YYYY
Place*

Dates	Passport Number