Apply

Please complete the form below or send an email to info@squicciarinifoundation.org.
We do our best to respond within 1-3 business days!

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Family Information

First Name*

Last Name*

Spouse's First Name

Spouse's Last Name

Street Address*

City*

State*

Zip*

Phone*

Email*

Name(s) and age(s) of children, if any:

Upload good quality photo of your family (limit 5MB)*

Employment

Occupation*

Employer*

How long have you been at this job?

Community

Name of Congregation*

Location of Congregation*

Leader's Name*

How long have you attended this congregation?*

Travel Plans

Have you been to Israel before? If so, when?*

Do you currently have plans for a trip to Israel? If yes, please provide the dates and estimated costs of the trip.*

What are your goals for visiting Israel?*

What is your reason for needing financial assistance with the travel cost?*

Reference

Please provide contact information for a reference, preferably at the congregation you attend:

Reference Name*

Reference Email*

Reference Phone*

SIGNED STATEMENT

I hereby attest that my motivations to visit the Land of Israel are good and honorable, that I have never received a travel grant from the Squicciarini Foundation, and that this pilgrimage is for the purpose of growing spiritually by learning about the history and geography of the Bible. I love the People, the Land, and the God of Israel, and I promise to abide by the laws of the Land of Israel while I am there.

If I am accepted for a travel grant, I authorize the Squicciarini Foundation to use my photographs and testimony for promotional and educational purposes.

By signing below, I/we hereby acknowledge that I/we have read this document and that I/we have had the opportunity to review and consider the information regarding the U.S. Department of State’s current position regarding travel to Israel and surrounding areas as available on this date from the Department. I/we hereby accept any and all risks to my/our life, health, well-being, safety, security and possessions which now exist and/or which may arise during the course of traveling to Israel, and, on behalf of myself/ourselves, my/our next-of-kin, my/our heirs or assigns, I/we hereby release The Squicciarini Foundation and any related or affiliated entities as well as their directors, officers, agents, and employees, from any and all claims which may arise during the course of or as a result of receiving a travel grant from The Squicciarini Foundation and spending time in the Land of Israel.

By signing below, I/we also agree to indemnify, hold harmless and defend The Squicciarini Foundation and any related or affiliated entities as well as any of their directors, officers, agents, and employees, against any and all claims, demands, liabilities, losses, damages, costs and expenses in any way relating to claims or demands made by me/us related in any way to the The Squicciarini Foundation’s Pilgrimage Project. The indemnification set forth in this paragraph shall include all expenses, penalties, fines, attorneys’ fees and disbursements which The Squicciarini Foundation and/or any related or affiliated entities may incur if any claims are made by me/us related to a trip to Israel made through a travel grant from The Squicciarini Foundation.

Upload picture of your U.S. driver's license or passport (limit 5MB)*

Signature (sign by typing your full name)*