BINA 2023-24 Gap Year in Israel Application - Personal Questionnaire
Thank you for taking your time to apply to BINA's Gap Year in Israel.
The application is made up of this personal questionnaire, followed by a medical form and 3 essay questions.
If you have any questions, please be in touch with Taylor Kleeman - Admissions and Marketing Coordinator - taylor@bina.org.il
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Email *
First Name *
Middle Name
Last Name *
Nickname
Preferred Pronouns (optional)
Date of Birth *
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Country of Birth *
Citizenship *
Passport Number *
If you have more than one passport, please write all with the Country issued and expiration dates, i.e. "USA 1234567 expires 01/01/2020; France B9876543 expires 01/01/2020"
Passport Valid Until *
If more than one passport, fill in for your primary passport
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