Benjamin

[pic]MASHAV
Centre for International Cooperation
Ministry of Foreign Affairs
Jerusalem

Dear Applicant,

We are pleased that you are applying for a study program in Israel. In order for us to consider your application, please complete the enclosed form (2 copies) and return them to the nearest Israeli representative (embassy or other).

Please make sure that allthe required information has been provided in detail. Either type your answers or print legibly. This will facilitate the application process and enable us to make our decision in as short a time as possible.

You will then be notified by the Israeli representative.

Thank you, and we wish you all the best for the future.

ESSENTIAL:
This application form must be either TYPED OR PRINTEDLEGIBLY IN THE LANGUAGE OF THE COURSE, and accompanied by the following:
Completed and approved medical certificate form
Certificate of language proficiency (If the language of the course/program is not your mother tongue or the official language of your country).
Photocopy of the relevant highest academic degree obtained translated to the language of course/program.
Three additional passportphotographs, apart from those affixed to the two copies of this application.
Two letters of recommendation: from present employers or affiliation.
These forms should reach the nearest Israeli representative at least ten weeks prior to course/program opening.

FOR OFFICIAL USE ONLY.
שגרירות/ נציגות ישראל במדינת __________________תאריך קבלת השאלון _____________

ראיינתי את המועמד/ת:אישית/טלפוני
הערכת המועמד/ת והתאמה לקורס:______________________________________________

____________________________________________________________

_____________

_________________ ________________ ____________ ________________
שם תפקיד חתימה חותמת השגרירות

* נא לשלוח העתק אחד למש"ב ואחד להשאירבנציגות
שאלונים שלא ימולאו במלואם כולל חלק זה בעברית לא יטופלו
במידה והמשתלם יתקבל לקורס, יש לציידו במכתב מטעמכם ולהסביר לו את סדרי הגעתו משדה התעופה למקום הקורס.

|[pic]MASHAV- Ministry of Foreign Affairs- |
| Centre for International Cooperation | |

1. General
Name of the course/training program_______________________________
____________________________________________________________

_
Name of training institution in Israel ________________________________
Dates: _____________ Language of the course___________________

Financial arrangements:
Flight ticket will be paid by__________________________________________________
Tuition and accommodation will be covered by _________________________________2. Personal Data
Surname_________________________________ Given Names ________________________ Country________________________ Citizenship ________________________
Religion________________________ Passport No. ________________________

Date of Birth_____________ Gender: Male / Female Marital status ____________________
Home address____________________________________________________________

________
____________________________________________________________

________
Telephone (country code______)(area code_______) Number __________________
Fax ___________________ e-mail ____________________________________
3.Education
| |Institute |Place |From/To |Subjectsstudied |Degree |
|Secondary school | | | | | |
|Technical School | | | | | |
|Vocational school |...