International MSc Program Application 2016-17
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Program you are applying to:
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Surname (exactly as on your
passport):
First and middle name (exactly as on
your passport):
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Country:
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Gender:
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Instructions:
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Double-click on the header section to enter your name and add a digital photo of yourself. To close the header,
click on the body of the form.
Save the application and add your name and program: Your Name_MSC Application_Plants
Email to: [email protected] or [email protected]
All sections below must be filled out. Where not applicable, type N/A.
1. PERSONAL INFORMATION
How did you hear about the international MSc program?
If you chose "other" please explain
Have you applied to the international MSc before?
If yes, in what year and for which program did you apply?
Date of birth DD/MM/YYYY
Passport number
Marital status
Email
Phone (Country code + Area/city code + Number)
Fax (Country code + Area/city code + Number)
Postal address
Skype username (we may interview you via Skype)
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2. ENGLISH PROFICIENCY
Please choose one*: Choose an item.
*You must enclose TOEFL or IELTS scores or English proficiency letter from your university.
3.
COMPUTER SKILLS
Word
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PowerPoint
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Experience with other computer programs:
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International MSc Program Application 2016-17
Copy/paste your photo here:
Program you are applying to:
Choose an item.
Surname (exactly as on your
passport):
First and middle name (exactly as on
your passport):
Click here to enter text.
Country:
Click here to enter text.
Click here to enter text.
Gender:
Choose an item.
4. ACADEMIC BACKGROUND
Institution of highest degree attained:
City and Country
Degree (Enter full name of degree)
Year completed
If not completed, expected completion date
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Click here to enter a date.
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Other academic institutions attended at college or university level:
Institution:
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City and Country
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Degree (Enter full name of degree) Click here to enter text.
Year completed
Click here to enter a date.
Institution:
City and Country:
Degree (Enter full name of degree)
Year completed:
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Click here to enter a date.
Other relevant higher studies:
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5. EMPLOYMENT
Current employer:
Position:
Date of employment:
Previous employer:
Position:
Dates of employment:
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6. ADDITIONAL RELEVANT EXPERIENCE
Experience in Israel, if any:
Dates:
Other experience:
Dates:
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International MSc Program Application 2016-17
Copy/paste your photo here:
Program you are applying to:
Choose an item.
Surname (exactly as on your
passport):
First and middle name (exactly as on
your passport):
Click here to enter text.
Country:
Click here to enter text.
Click here to enter text.
Gender:
Choose an item.
7. ASSESSMENTS
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The assessment form (on our website) must be filled in by the assessor and mailed directly by him/her to the
International School postal address. Or it can be scanned and emailed directly by the assessor from his/her
university or organization email address. Assessments/recommendations may not be handled by the applicant.
List below three assessors. At least one academic assessor is required.
The two other assessors may be academic or professional. She/he must have known you for at least one year
(e.g., teacher, trainer, advisor, employer).
1. Name of assessor:
Position:
Email address:
2. Name of assessor:
Position:
Email address:
3. Name of assessor:
Position:
Email address:
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8. SCHOLARSHIP INFORMATION
Visiting students must have sufficient funds to be able to complete their studies. Funding sources may be a scholarship,
personal savings, student loan or financial support from family or friends. To protect you from a possible situation in
which you cannot complete your studies, you are requested to ensure that your funding is sufficient for the entire
duration of the program.
Will you be applying for a scholarship through the Hebrew University? Choose an item.
 If Yes- A separate Scholarship Application must be submitted.
 If No- Please indicate your funding sources below:
Funding Sources (including personal and family)
1. Click here to enter text.
2. Click here to enter text.
3. Click here to enter text.
Amount in US Dollars
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International MSc Program Application 2016-17
Copy/paste your photo here:
Program you are applying to:
Choose an item.
Surname (exactly as on your
passport):
First and middle name (exactly as on
your passport):
Click here to enter text.
Country:
Click here to enter text.
Click here to enter text.
Gender:
Choose an item.
9. PERSONAL STATEMENT (250 word limit!)
Please tell us about yourself in 250 words or less (use "Word Count" to keep track). Please do not cut and paste words
from the Internet. We prefer hearing about "you" rather than about Israel's agriculture, the Hebrew University's
reputation, or statistics about your country.
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DECLARATION
I, the undersigned, certify that all information supplied in this application is complete and correct. I understand and
agree that the Hebrew University reserves the right to take any necessary measures in connection with candidates who
submit partial, incorrect and/or false information. I waive my right to privacy regarding all academic documentation
relevant to processing this application.
Name: Click here to enter text.
Declaration: Choose an item.
Date: Click here to enter a date.
PHOTO RELEASE PERMISSION
If I am accepted to the program, I hereby give my permission to be included in any Hebrew University of Jerusalem
photos, videos or interviews, and for the information collected by the media to be used as part of news stories, public
relations and marketing collateral to be published in print, Internet, broadcast or video by the University or media. I
understand that images and/or filmed or audio recordings will not be used for commercial gain and will not be sold to
anyone for commercial use.
Name: Click here to enter text.
Declaration: Choose an item.
Date: Click here to enter a date.
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