APPLICATION FOR RENEWAL APPLICANTS - SPRING 2006
TODAY'S DATE
FIRST NAME
MIDDLE NAME
FAMILY NAME
VISA TYPE
DATE OF BIRTH (MM/DD/YYYY)
STUDENT NUMBER
US PHONE NUMBER
E-MAIL
FLORIDA ADDRESS
FLORIDA CITY
ZIP CODE
COLLEGE YOU ARE ATTENDING
MAJOR
DEGREE YOU ARE SEEKING
ISRAELI CONTACT NAME
ISRAELI CONTACT ADDRESS
ISRAELI CONTACT CITY & ZIP CODE
ISRAELI CONTACT PHONE
ISRAELI CONTACT E-MAIL
MAY WE INCLUDE YOUR NAME, ADDRESS AND PHONE NUMBER ON A MAILING LIST THAT WE DISTRIBUTE TO OTHER ISRAELI STUDENTS IN FLORIDA? YOUR ANSWER WILL NOT AFFECT YOUR SCHOLARSHIP
NUMBER OF CREDITS YOU ARE ASKING FOR
EXPECTED GRADUATION DATE
SEMESTER UNDERGRADUATE
GRADUATE
ADVISOR'S NAME
SPRING 2006
CLASS STANDING
ESSAY QUESTIONS (PLEASE FILL IN THE BOXES BELOW)
1. Is there anything special that we should take into consideration when reviewing your application?
2. How many credits from the credits we awarded you in Spring and Summer 2005 did you use and at which school? (Example: 3 at Miami-Dade College and 6 at FIU)
3. What community Service have you performed this semester? Include the name and phone number of the person or organization you helped
After clicking the SUBMIT botton you should get a screen with your application. It usually means that the process went OK and we should get your application electronically. However,we strongly recommend that you contact us after submitting the application to make sure we actually got it.