Passport Information
Please scan the page in your passport where you have your photo, name, and the other information requested here, and send to You probably already have been asked to provide a copy to International Programs via the Cowboys Abroad portal. If requested, please upload the scan also in Wyogroups or any other location.

It is important to fill out the information requested EXACTLY as it is in the Passport you will use for your travel (even if the information is wrong or outdated). For example, enter your name exactly as in your passport, regardless of whether you currently use the name in your passport for any other purpose. (By the way--Make sure the name on your air ticket matches the name on your passport, or at a minimum that they have the name on your passport in their records!)

Email address *
Do you currently hold a valid passport that is valid for at least six months after you plan to leave Israel?
If your Passport is not valid until next January, you will need to renew.
Name exactly as on Passport
Your answer
Nationality to be used on passport to enter Israel (USA or name of other country)
Your answer
Passport #:
Your answer
Date of Birth as shown on passport:
Your answer
Place of Birth as shown on passport:
Your answer
Sex shown on Passport
Your answer
Passport Date of Issue:
Your answer
Passport Date of Expiry:
Your answer
Passport Authority or Place of Issue as shown on passport (For US passports, often United States Department of State):
Do you hold any additional citizenship or nationality?
Please note the additional citizenship if you do, even if not relevant to entering Israel. Otherwise answer No.
Your answer
Have you ever been outside the United States?
Emergency contact info: *
Please note phone(s) and email(s) for each contact.
Your answer
A copy of your responses will be emailed to the address you provided.
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