1. My year of birth is
  2. My gender is: male female
  3. I am:   
  4. The number of my children aged 17 or under
      The number of my children aged 18 or over   
  5. The highest educational degree which I earned is:
  6. My current occupation (or my latest occupation) is
  1. My country of birth is
  2. My current country of residence is
  3. I left Israel in the year
  4. I am a citizen in my country of current residence: Yes No
  5. I have citizenship of another country
  1. I am in touch with the Jewish community establishments in my place of residence:
     synagogue:
     I, or someone else in my household, participate in social and cultural activities of the community: Yes No
      My children are, or were, members in a Jewish/Israeli youth movement: Yes No
  2. I define myself as:
  3. I define myself as:
  4. I observe the following customs:
      Kashruth observance (separation of dairy and meat dishes): Yes No
     Fasting on Yom Kippur: Yes No
      Lighting of Hanukkah candles:
     Participation in a Passover seder: Yes No
  5. My children receive, or received, a Jewish education in our Diaspora place of residence:
  1. I know Hebrew:
     Speech: 
     Reading:
     Writing:  
  2. I visit Israel:
  3. I maintain contact in Israel with:
     family: 
     friends:
  4. Of my closest friends where I live, Israelis make up:
  5. I am in touch with official Israeli institutions in my country of residence:
     Israeli Consulate:  
    Israel House :          
    Jewish Agency representatives:         
  6. I, or someone else, in my household:
     Read printed or electronic news in Hebrew:
     Listen to radio programs in Hebrew:   
     Watch television programs in Hebrew:
     Surf on Israeli web sites in Hebrew (other than newspapers):
     Listen to Hebrew music:
     Watch Israeli movies:    
     Read Hebrew literature and poetry:
  7. The following types of activities are important to me and I would be interested in participating in them:
     Social-cultural including only local Israelis (for example: trips, folk-dancing, Israeli festivals [film, food, etc.]):
     Meetings with Israeli public or political figures:
     Cultural and social events with Israeli artists/intellectuals/academics:
  8. In my opinion to allow Israelis in the Diaspora to vote in the Israeli elections from their places of residence.
  We would be happy to receive your comments on this questionnaire.
 
  If you would like to, please send us your email address.