Campus Ambassadors Interest Form

The CRC, in partnership with Hillel JUC, is taking ten students to Israel from March 5–15, 2026. All information provided will be held in confidence via the Jewish Federation of Greater Pittsburgh and only shared with essential travel partners.

"*" indicates required fields

Participant Information

Legal Name (as it appears on passport)*

First Last

I certify that the name listed above is the same name that appears on my passport.*

I agree

Preferred Name

First Pronouns

Email*

Cell Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Current University*

Year in school*

Major*

Passport Information

Country of Birth*

Passport Number*

Sex (as listed on passport)

Passport Expiration Date*

MM slash DD slash YYYY

Please upload a copy of your passport*

Max. file size: 128 MB.

(Passports must be valid for a minimun of six months after March 15)

Do you hold an Israeli passport?*

Yes

Israeli Passport Number*

Israeli Passport Expiration Date*

MM slash DD slash YYYY

Emergency Contact Information

Emergency Contact Name*

Relationship

Emergency Contact Email*

Emergency Contact Phone*

Jewish Information

This participant has at least one Jewish parent OR has converted through a recognized Jewish denomination such as Reform, Conservative, or Orthodox.

Please pick one identity

Traditional

Reform

Culturally Jewish

Conservative

Orthodox

Other

Dietary Restrictions

Most of the meals on this trip will be prepared in a kosher (Rabbanute) kitchen. However, some of them might be vegetarian meals prepared in a non-kosher kitchen. For those meals there will be an option to have a “bagged” kosher meal.

Please indicate what level of kosher you observe:*

I will only eat food prepared in a kosher kitchen

I will only eat meat prepared in a kosher kitchen but I will eat a vegetarian meal prepared in a non kosher kitchen

I do not keep kosher

Other

Do you have any dietary restrictions (gluten free, dairy free, vegetarian, etc.)?*

Yes

Please list all dietary restrictions.*

Accessibility Accommodations

This trip involves long days with heavy amounts of walking, various amounts of rigorous physical activities, sitting in buses that go up winding hills, and eating unfamiliar foods. You will need a note from a healthcare provider ensuring that you are in fit physical condition to walk up to seven miles in one day.

Please list all allergies, prescriptions and medical conditions.

Insurance Provider*

Name on card*

First Last

Member Number*

Group Number*

Please attach a photocopy of your insurance card (front and back)

Drop files here or

Max. file size: 128 MB.

Please share any accessibility needs you have to help our team best accommodate your experience on this mission.

This trip involves going to places where traumatic events have occurred such as the site of the Nova Music Festival. Topics that this trip may include are and are not limited to: War, sexual violence, murder, terrorism, displacement and other extremely heavy topics. If you are actively seeking psychological counseling, please submit a note from your mental health care provider certifying that you are in a health psychological state to fully participate.

Max. file size: 128 MB.

Room Assignments

During this trip you will be sharing a room with up to two other people.

Rooming Preference

Male room

Female Room

Mixed gender/nonbinary-identifying room

Roommate preference

First Last

This is not guaranteed but will be considered.

Agreements

Photo Release and Liability Agreement*

By registering for this event, you agree that your (and your guest’s) picture and/or video may be taken and potentially used in Jewish Federation marketing material and social media.

Yes, I (we) agree.

App Download Requirement*

Safety is our number one priority, and we will be in constant contact with our partners at Israeli Central Security (Moked Teva) and Jewish Federations of North America. By signing up for this trip you agree to download the Homefront Command App before arriving in Israel.

Yes, I (we) agree.

E-Sim Agreement*

You are responsible for having an E-sim or Israeli cell phone data plan that is valid during the duration of this trip.

Yes, I (we) agree.

By participating in the Campus Ambassadors program, you are agreeing to the following:*

You will attend all pre-trip sessions and post-trip educational sessions and will commit to Israel advocacy and peer education on your campus for a minimum of one year after the trip.

You will complete a post trip student engagement project and will commit to promoting meaningful conversations about Israel with your peers on your campus.

You will participate in every educational session on and off the trip to Israel to the best of your physical and mental ability.

You will abide by all the safety instructions given to you by the tour guide, Israeli security professions, and Hillel JUC/ Federation staff members.

Speaker Respect Agreement*

Over the course of the Campus Ambassadors cohort, we will be hearing a diverse range of perspectives. As a Campus Ambassador you agree to hold nuanced conversations, to listen more than you speak, to focus on using I statements when speaking, to holding multiple realities at the same time and to focus on the speaker as a wholistic human being.

Yes, I (we) agree.

Phone

This field is for validation purposes and should be left unchanged.

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Participant Information

Passport Information

Emergency Contact Information

Jewish Information

Dietary Restrictions

Accessibility Accommodations

Room Assignments

Agreements

More Information