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registration form
1
Student Details
2
Previous Studies
3
Hobbies
4
Parent Information
5
Summary
If you have any questions or need help filling out the form, please contact us:
ira.lotman@wokm.org | 03-9244438
World ORT Kadima Mada, Atid Yeda 7, Kfar Saba
1. Student Details
2. Previous Studies
3. Hobbies
4. Parent Information
5. Summary
Personal
Information
First Name
Last Name
Teudat Zehut no'
Male/Female
Birthday
No. of siblings up to age 18
Studies
Contact
Information
School Name
Current Grade
Contact
Information
Student's Email Address
Mobile Phone Number
Home Phone Number
Previous studies:
Please specify the details of the last school<
Years
Boarding school
School Name
From grade to grade
Please specify hobbies, interests, volunteering or leisure activities
Details of
parent
guardian
father
mother
First Name
Last Name
Phone
Email
Profession
Street
City
Postal Code
Details of
parent
guardian
father
mother
First Name
Last Name
Phone
Email
Profession
Street
City
Postal Code
Add another custodial parent
previous stage
next stage
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