The Many Faces of Israel
Registration Form
Name ____________________________ Age __________ Date of Birth ___/___/_____
Month Day Year
Permanent Address _______________________________
_______________________________
Name of University _______________________________
Home Phone ________________________
Social Security/Social Insurance Number ___________________
E-mail Address ___________________
Passport Number ___________________ Country of Citizenship _____________
Dates of Activity ___________________
Request for Transcript
Upon successful completion of the course you will be entitled to get ONE official transcript, which will be sent to the address listed below. A copy will also be sent to your home address.
Please make sure you fill in the exact address the transcript has to go to:
__________________________________
__________________________________
___________________________________
___________________________________
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P.O.B. 2135
Kfar-Saba 44641
Israel
(Phone) 972-9-767-4477
(Fax) 972-9-767-4481
(Toll-Free from USA) 1-888-351-9897
(Toll-Free from Canada) 1-866-269-6889
E-MAIL: Credits@OranimIsrael.com