Counseling questionnaire for prospective students



Fields marked with a red triangle () are mandatory.

Personal details

ID Number :

Last Name :

First Name :

Country :

Telephone:

E-mail :

 Male     Female

Contact person in Israel

Last name :

First name :

Relationship :

Address:

City:

Zip code:

Telephone :

Mobile :


Background and education

Years of education:

Matriculation certificate:

Yes No

Other certificate:

Level of mathematics:

Final grade

Post-secondary education:
You may apply for accreditation of prior studies

Highest grade completed (regular studies):

Occupation:

What is the purpose of your studies?

Purpose of studies:

Have you selected a study track?

No  Yes. Which track?  
Selecting a course: For help, see tables "selecting introductory courses" and "selecting introductory courses for dual-disciplinary programs".

Course

English language proficiency

There are three ways to demonstrate evidence of English language proficiency (see details here).
Check the way you wish to fulfill this requirement:

Through exemption based on prior studies at another University, awarded by the Accreditation Committee

By receiving a grade granting exemption on the English proficiency test (Amir / Amiram) or the English section of the psychometric test.

       Have you taken a proficiency exam in the past?  Yes   No

 By passing an A-level English course at the Open University


Counseling questionnaire: