Application Form | Bat Kol Institute

Name: *

Family name: *

P.O.Box: *

Post Office Box number

Postal Code: *

State/Province: *

Country, City & Street address: *

Country, City & Street address

Mobile number:

Phone number:

Please enter phone number including country code first: Country code Area code Phone

Fax number:

Please enterfax number including country code first: Country code Area code Fax

Citizenship: *

Email address: *

Passport number: *

Country of residence: *

Visa to Israel, please enter yes or no:

Do you require a visa for Israel ?

Denominational Affiliation: *

Study program requested: *

Please list study program you are applying for, 2009, 2010, or both.

Academic record and degrees: *

Academic record and degrees, other courses taken, name of educational institution, year, and area of subject concentration

Religious and Academic titles : *

Academic credit, please enter yes or no: *

Are you applying for academic credit?

Present work: *

and a brief history of your employment during the last four years. Describe any involvement in volunteer and church activities outside your normal work.

Indicate background: *

Indicate any background you have in Jewish Studies, Hebrew language, Hebrew Scriptures, related experiences that may enhance your participation in this course.

Previous visits to Israel, dates and purpose: *

How did you learn about Bat Kol: *