Fellow Request to Transfer Stipend to Home University

I hereby request that my monthly stipend from the Israel Institute for Advanced Studies be paid directly to my home university.

I am aware that the IIAS is entitled to deduct any payments owed to the IIAS from my stipend, prior to transferring the payment to my home university.

Name (First,Last) *

E-mail address *

Research Group at the IIAS *

Dates of Residency (Arrival and Departure) *

Name of Home University *

Home University Full Address *

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