Please wait while we find a match for your details.


Title *

First name (as on passport) *

Middle names (as on passport)

Last name (as on passport) *

Known as (if different to above)

Gender *

Date of Birth (DD/MM/YYYY) *


Contact Info

Email Address *

Confirm Email Address *

Mobile *

Home Address

Address Line 1 *

Address Line 2

Town/City *


Postcode *


Home Phone

University *

Specify University Name

Year of University Graduation *

Degree Subject *

Term Time Address

Address Line 1 *

Address Line 2

City Area

Town/City *


Postcode *

Login Info

Username * (please choose a username - min. 8 characters)


Which campus programme are you applying for? *

Did a Genesis Rep/Campus Ambassador recommend the programme to you? *
Yes     No

Please specify the name(s) of the Campus Ambassador(s)/Rep(s).

Please specify where did you hear about the Genesis Programme? *

Primary School *

Secondary School *

Are you affiliated with any youth group(s)? If so which ones: *

Have you attended an Israel Summer Tour? If so which one: *

Have you had any previous involvement with Aish?
If yes please give details: *

Are your family affiliated to a Synagogue? If so please provide details: *

Other people who are potential candidates for Genesis:


Please tick if you are interested in:

A Trip to South Africa

A Trip to Poland

A Trip to Odessa

  Please tick this box to accept the Terms & Conditions

Terms & Conditions

I affirm that all the information provided in this application is true, and understand the Genesis guidelines enumerated below:

I understand that in order to receive the full scholarship I will need to attend the entire programme (minimum of 12 sessions). I also understand that failure to attend the above stated events will result in a partial deduction from programme stipend. I will comply with all basic standards of programme conduct in a manner befitting a Genesis student. Genesis reserves the right to ask any student to discontinue participation for any reason it sees fit, without paying any stipends.A personal interview will be required before final admission. For the purpose of the Data Protection Act 1998 (as amended) you give your consent to the holding, processing and accessing of personal data relating to yourself. Aish UK, including donors of Genesis, will process such data only for legitimate reasons and will do so in a way which does not unjustifiably prejudice your own interests. This information will be held in strict confidence. By attending any Genesis events, you consent to being photographed / videoed, and the images being used on future publicity material.