2025 2026 Fellow Questionnaire (Israeli)

PERSONAL INFORMATION

First Name *

Last Name *

Israeli ID Number *

Upload Photo *

Please upload a high resolution color head-shot photo of yourself. It should be 300 dpi or a large sized photo. The photo will be used for IIAS publications.
More information

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

E-mail address *

Cell Phone number *

Home Address *

Personal Website *

RESIDENCY INFORMATION

Research Group/Individual Fellowship at the IIAS *

Duration of Stay and tentative dates of arrival and departure *

Residency Track *

See description of the different tracks: https://iias.huji.ac.il/residency-terms-conditions-israeli-universities

Comments on Residency Track

ACADEMIC INFORMATION

Name of Institution *

Department *

Institution Address *

Work Phone

Academic Status *

Area/s of Research *

IT INFORMATION

Will you need a desktop computer in your office? *

Yes

Please specify your preferred operating system *

Will you be using your own laptop in your office? *

Yes

Please let us know if you require any accessories (e.g. keyboard, mouse, screen)

MEDICAL INFORMATION

Food Allergies/Restrictions *

Yes

Please indicate what the allergies/restrictions are

Accessibility

Please let us know if you or any members of your family have any accessibility limitations

Emergency Contact Person ( full name,proximity, cell phone number ) *

ADDITIONAL COMMENTS

ADDITIONAL COMMENTS