Registration Form for Israeli Students

Be sure to fill in all required information. This information will be used in the Certificate of Participation for the course.

For students taking the I-CORE course, we must have your Ishur limudim bein mosdi (אישור לימודים בינמוסדי) to register for the course.

For registration questions please contact Program Coordinator:

03-640-5965

Last date to register: May 31

First Name (in Hebrew) *

Last name (in Hebrew) *

First Name (in English) *

Last name (in English) *

Teudat Zehut No. or Passport number *

Date of Birth *

Month

Day

Year

Country of Birth *

Gender *

Female

Male

Mailing Address *

Residential Address (if different from mailing address)

Cell Number *

Alternate Phone Number

Email *

Place of Employment

Highest Academic Degree achieved

CV (pdf/doc/docx only) *

Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Registration Number (found on receipt)

Signed inter-university agreement form (possible to send later via email)

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc ppt.

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