Registration Form
For sake of issuance of invitation letter:
*
First Name
Middle name
*
Last Name
*
Affiliation (university, institution)
*
Nationality
*
Israeli Id / Passport number
For sake of workshop tag:
*
Name (first, middle, last)
*
Affiliation
Contact information:
*
Address line 1
Address line 2
*
Street and number
*
City
*
Country
*
Zip Code
*
E-mail address
Office phone
*
Cell phone
Fax
Workshop presentation:
Title
Upload document (in Word or PDF formats):
Upload File
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Maximum File Size Allowed Is 2 MB
Co-author 1 (full name, affiliation, e-mail address)
Co-author 2 (full name, affiliation, e-mail address)
Co-author 3 (full name, affiliation, e-mail address)
Co-author 4 (full name, affiliation, e-mail address)
Co-author 5 (full name, affiliation, e-mail address)
Tours -- No need to commit now, but please do give us an indication, to help us plan ahead… Are you thinking of joining us for the following?
*
Workshop dinner
No added fee
-- select an option --
Yes
No
*
Guided walking tour of Jerusalem’s Old City, Saturday 18 March 2017, 14:00-18:00
Fee: 28$ USD
-- select an option --
Yes
No
*
Bus tour to the Judea Desert, Masada and the Dead Sea, Tuesday, 21 March 2017, 8:00 - 15:00
Fee: 70$ USD
-- select an option --
Yes
No
*
Status
-- select an option --
Faculty
Non-Israeli student
Israeli student
Faculty
160$ USD
Non-Israeli student
110$ USD
Israeli student
55$ USD
Fields Marked with (*) are required
