Green Apprenticeship Application
Please note: Application takes on average 10 - 20 minutes to complete.

• All courses are in English unless otherwise indicated.
• Notifications of acceptance will be made on a rolling basis, generally within 2 weeks of the receipt of an application.
• Accommodations are shared (2-3 students to a dome). Couples will be able to share a dome.
• Our ability to offer financial aid is limited.

* Staff of Center for Creative Ecology may request an interview.

To apply, please complete and sign this form and send us the following via email:
1. A photocopy of the first page of your passport/ id card (including your picture).
2. C.V. / resume showing where you have studied, worked etc.

On notification of acceptance to the program, all participants are required to pay a deposit of 1000 ILS in order to ensure their place. The deposit is non-refundable in the event of cancellation prior to the commencement of the program. Remaining fees are payable prior to arrival to Lotan.

Please feel free to contact us with any questions you may have with regards to the course or kibbutz in general.

Please email all required documents to: admissions@klotan.co.il

Center for Creative Ecology
Kibbutz Lotan
Hevel Eilot
8885500 Israel

Green Apprenticeship Application Form

(Please type directly on the form. Use the tab key to move between fields. Check boxes by clicking with the mouse.)
First Name *
Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
For purpose of room assignments
Permanent Home Address *
Home Telephone *
Mobile Phone *
Email *
Passport Number / Israeli ID *
Country of Origin *
Date of expected arrival to Israel *
Date of expected departure from Israel *
Select which Green Apprenticeship course you are applying for *
All courses are in English unless otherwise stated
Emergency Contact Information *
Telephone Contact
Higher education
Please provide name of university/ college, degree (BA, MA etc), field of study and date of graduation
Any other relevant courses you have participated in?
Please give details
Do you have any previous experience with group work? Please give details.
Have you previously participated in a permaculture design course?
If yes, where and when? Who were the facilitators?
Have you previously visited Israel? If yes, where and when?
Youth movement experience -- which and at what age
Hobbies, interests, skills
Work experience *
Religious and congregational affiliation
What attracts you to this course? *
What would you like to receive or learn from this course? *
What skills or attributes will you bring with you to share? *
What do you imagine might be your greatest challenge during the program? *
How did you hear about the Green Apprenticeship? *
Please give details -- for example, if you know someone who did the course, tell us who it was. If it was an online search, what were the search terms you used.
Please indicate the appropriate assessment (in your opinion) of your present health *
Do you suffer from any major health problems? *
Please provide as much detail as you can
Do you have any physical and/or emotional limitations we should know about? If yes, please explain. *
Are you taking any medications on a regular basis? *
Diet *
Very important: Please indicate any food allergies/ sensitivities that you have. Vegetarian diets are always available, but we cannot guarantee completely vegan diets. No meat or fish allowed in the eco-campus field kitchen (although available in the kibbutz dining room). Please indicate all that are applicable
Required
Details of food allergies/ sensitivities
Declaration of Health Status *
I hereby declare that I have suffered, or presently suffer from, the following conditions:
Required
If you checked any of the boxes above, please give details
When was the last time you were examined by a licensed physician for the above named conditions?
Have you ever been hospitalized? *
Please give details
Declaration of Health Status *
1. I agree to disclose to the doctors and to any medical caregiver who shall examine me, full and correct information concerning every illness and defective condition that I have experienced in the past, and that I do not suffer from said illnesses today, and that I am not concealing information. 2. I hereby waive my right of medical confidentiality to Kibbutz Lotan, concerning any illness or condition that I suffered in the past, or that I suffer from today. I hereby agree that any physician or medical institution that shall treat me, will disclose full information regarding the above, and shall not lodge any complaint or suit of any kind to a health fund or its employees involved in forwarding the above-mentioned facts, or conclusions based on them. E-signature:
Cancellation and Refund Policy Agreement I, the undersigned, agree to the following: 1. If I cancel my participation before the start of the program, the deposit of 1000 ILS will not be refunded. 2. If I decide to leave the program within two weeks of the program start date, 25% of the course fee less any additional costs incurred will be refunded. 3. If I decide to leave after the first two weeks of the program, I am not entitled to any refund. 4. If I am asked to leave the program by the organizers for whatever reason, I am not entitled to any refund. *
E-Signature (Name)
I declare that the details I have given in this form are all true. I am aware of the following Lotan norms and arrangements: 1. Possession of illegal drugs or participation in other illegal activity according to the laws of the State of Israel will result in being turned over to the police and being asked to leave the kibbutz. 2. Excessive use of alcohol may be grounds for dismissal from the program. 3. Green Apprentices may not keep pets. 4. NO SMOKING in rooms or in any undesignated area. 5. Green Apprentices may not remove furniture from their rooms, nor may they make structural changes, paint on walls etc. 6. Green Apprentices may invite guests only with permission. Green Apprentices will be charged for their guests' meals. 7. Participants agree to abide by the eco-campus' field kitchen conditions: kosher dairy, no meat, no fish. 8. Green Apprentices are expected to participate in all educational activities organized on their behalf. *
E-Signature (Name)
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