" & _ "
First Name (please include middle name): "&firstname&"
" & _
"Hebrew Name (please include middle name): " & hebrewname & "
" & _
"Last Name: "&lastname&"
" & _
"Date of Birth:"&birthdate&"
" & _
"Age: "&age&"
" & _
"Place of Birth"&placebirth&"
" & _
"Anticipated date of Arrival in Israel:"&arrivalDateIsrael&"
" & _
"Anticipated date of departure:"&departureDateIsrael&"
" & _
"Permanent Address Abroad:"&permAddressAbroad&"
" & _
"Phone Number:"&homephone&"
" & _
"email:"&email&"
" & _
"Citizenship:"&citizenship&"
" & _
"Passport Number:"&passportnum&"
" & _
"Social Security No."&socialsecuritynum&"
" & _
"Mothers Full Name:"&mothersname&"
" & _
"Fathers Full Name:"&fathersname&"
" & _
"Was your mother born Jewish?
" 'response.write "
Line 49:" & body if jewish="yes" then body = body &"Yes, mother born Jewish
" else body = body &"No, mother not born Jewish
" end if body = body & "
If not, please give details (i.e. converted, etc.
" & _ "
" & _ "
Father's Occupation"&fathersoccupation&"
" & _
"Mother's Occupation"&mothersoccupation&"
" & _
"Parents Marital Status:
" if married="married" then body = body & "married
" else body = body & "married
" end if if divorced="divorced" then body = body & "divorced
" else body = body & "divorced
" end if if other="other" then body = body & "other
" else body = body & "other
" end if body = body & "
Years of education completed (starting with 1st grade):"&yearseducation&"
" & _
"List all post-high / secondary schools you have attended: (School, Major, Dates, Gradutated?, Honors?)
" & _ "
" & _ "
What Jewish Education have you had?
" body = body & "
" 'if VirtuallyNone="VirtuallyNone" then 'body = body & "VirtuallyNone
" 'else 'body = body & "VirtuallyNone
" 'end if 'if JewishDaySchool="JewishDaySchool" then ' body = body & "JewishDaySchool
" 'else 'body = body & "JewishDaySchool
" 'end if 'if YeshivaHighSchool="YeshivaHighSchool" then 'body = body & "YeshivaHighSchool
" 'else 'body = body & "YeshivaHighSchool
" 'end if 'if SundaySchoolpre13="SundaySchoolpre13" then 'body = body & "SundaySchoolpre13
" 'else 'body = body & "SundaySchoolpre13
" 'end if 'if SundaySchoolpost13="SundaySchoolpost13" then 'body = body & "SundaySchoolpost13
" 'else 'body = body & "SundaySchoolpost13
" 'end if body = body & "
Your Jewish Orientation:
" if Reform="Reform" then body = body & "Reform
" else body = body & "Reform
" end if if Conservative="Conservative" then body = body & "Conservative
" else body = body & "Conservative
" end if if Orthodox="Orthodox" then body = body & "Orthodox
" else body = body & "Orthodox
" end if if Unaffiliated="Unaffiliated" then body = body & "Unaffiliated
" else body = body & "Unaffiliated
" end if if RecentlyObservant="RecentlyObservant" then body = body & "RecentlyObservantbr>" else body = body & "RecentlyObservant
" end if body = body & "
Have you been a member of Jewish organizations?
" if memberjewishorg="yes" then body = body &"Yes, member of jewish organization
" else body = body &"No, not member of jewish organization
" end if body = body &"
Have you ever been to Israel?
" if beeninIsrael="yes" then body = body &"Yes, I have been in Israel before
" else body = body &"No, I have not been in Israel before
" end if body = body & "
Have you ever been on Birthright?
" if beeninIsrael="yes" then body = body &"Yes, I have been on birthright before
" else body = body &"No, I have not been on birthright before
" end if body = body & "
Have you ever been on any Aish programs?
" if aishprogs="yes" then body = body &"Yes, I have been on an Aish program
" else body = body &"No, I have not been on an Aish program
" end if body = body & "
If Yes, what program and when?
" & _ "
" & _ "
How did you hear about the Intermediate Program?" & hearprogram & "
" & _
"Are you currently taking any medication?
" if takingmedication="yes" then body = body &"Yes, I am taking medication
" else body = body &"No, I am not taking medication
" end if body = body & "
Have you previously taken any medication?
" if prevtakingmedication="yes" then body = body &"Yes
" else body = body &"No
" end if body = body & "
If Yes, please elaborate:"&elabtakingmedication&"
" & _
"My 4 Life Priorities are:
" & _ "
" & _ "