Conversion Application

Thank you for your interest in our conversion program. To begin your application, please fill
out all sections of this form. We’ll need information about your background, residence, education, and reasons for wanting to convert.

If you have a partner or spouse, they should also complete their section of the form and be
present for the initial interview.

Process for initial interview for purposes of conversion

Terms and notes

Handwriting Analysis: The handwritten sections will be sent for handwriting analysis at a cost of R920 (incl VAT). You will need to bring the originals of your uploaded documents when you come in for your initial interview.
The following books must be read carefully by you and your partner (if applicable) before your
initial interview.
1. Real Messiah by Aryeh Kaplan – can be obtained online.
2. Becoming a Jew by Maurice Lamm – can be obtained at a Jewish book shop.
Initial Interview fee: A fee of R1250 is required for the initial interview.
Psychological Evaluation: We reserve the right to send you for psychological evaluation which
should be covered by medical aid.
You will only be accepted onto the programme if you are a permanent resident of RSA and have permanent employment. Please attach confirmation of employment as well as a copy of your latest
salary slip if applicable. If you are self-employed please indicate your average monthly income.
Please attach proof of ownership of property or lease agreement for your home.
If you are accepted to be registered on the conversion programme there will be a further charge
of R4730 which is a non-refundable administration fee.

Note:

All information herein is confidential but can be shown to the Community Security Organisation
for security purposes.
This application form does not mean that you have been accepted onto the conversion course.
You will be informed in writing when you have been accepted.

Terms and notes

Handwriting Analysis: The handwritten sections will be sent for handwriting analysis at a cost of R860 (incl VAT). You will need to bring the originals of your uploaded documents when you come in for your initial interview.
The following books must be read carefully by you and your partner (if applicable) before your
initial interview.
1. Real Messiah by Aryeh Kaplan – can be obtained online.
2. Becoming a Jew by Maurice Lamm – can be obtained at a Jewish book shop.
Initial Interview fee: A fee of R1250 is required for the initial interview.
Psychological Evaluation: We reserve the right to send you for psychological evaluation which
should be covered by medical aid.
You will only be accepted onto the programme if you are a permanent resident of RSA and have permanent employment. Please attach confirmation of employment as well as a copy of your latest
salary slip if applicable. If you are self-employed please indicate your average monthly income.
Please attach proof of ownership of property or lease agreement for your home.
If you are accepted to be registered on the conversion programme there will be a further charge
of R4730 which is a non-refundable administration fee.

Note:

All information herein is confidential but can be shown to the Community Security Organisation
for security purposes.
This application form does not mean that you have been accepted onto the conversion course.
You will be informed in writing when you have been accepted.

"*" indicates required fields

101. Application form

202. Payment

Cost

Handwriting Analysis – R920.00
Initial Interview – R1250.00

Total – R2170.00

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Which city would you like to apply through?

All fields to be filled in. If not applicable, state N/A.

Please select a city

Johannesburg

Durban

Cape Town

Port Elizabeth

Other - please specify

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Personal Information

Full name*

Date of birth*

Place of birth*

Name of birth mother*

Name of birth father*

Religion*

Describe past religious involvement*

Is there anyone in your family that has converted?*

Contact Information

ID/Passport number:*

Car registration number*

Current physical address*

Contact numbers (home/work/cell)*

Email*

Education and Occupation

School attended*

Tertiary qualifications*

Tertiary institute attended*

Current occupation*

Employers name/Reference person**

Place & address of work and how long have you worked there for*

Employer’s/Reference person contact number*

How long have you worked there? (Years/Month)*

Marital and Relationship Status

What is your marital status?*

Name of partner/romantic interest*

Partner’s date of birth*

Parent’s names of partner*

Partner’s ID number*

Partner’s car registration number*

Partner’s email*

Partner’s physical address*

Contact numbers of partner (Home/Work/Cell)*

Marital status of partner*

Religion of partner*

If partner is Jewish, when and where were parents married?*

If partner is Jewish, Kohen, Levite, or Israel**

Is there anyone in your partners family that has converted?*

Children

Names of children with dates of birth*

Schools children attend**

Are there children from a previous marriage? If yes, please state names and birthdates*

Name of parent they reside with*

Background Information

Do you have a criminal record? (Police clearance may be required)*

Do you suffer from any physical health conditions? (If yes, please provide details)*

Are you on any medication for physical health conditions? (If yes, please provide details and doctor’s letter)*

Do you have or ever had any learning disabilities? (e.g, ADHD, Dyslexia) (If yes, please provide details)*

Are you or have you used medication for learning disabilities? (If so, please provide details and a doctor's letter)*

Can you read Hebrew?*

How fluent is your reading?*

If no, please specify any reasons you may struggle to read*

Mental Health and Substance Abuse

Do You Suffer or Have You Ever Suffered from Any Mental Health Problems?*

Have You Been Involved in Substance Abuse in the Past? (Please provide details)*

Additional Information

Professional/Social Organizations You Belong/Belonged To*

Have You Read the Recommended Books?

Real Messiah by Aryeh Kaplan - can be obtained at a Jewish book shop.

Becoming a Jew by Maurice Lamm - can be obtained at a Jewish book shop

Is there any other information you think we should know?*