Staff Week Application 27.11.2022-01.12.2022

Staff Week dates are 27.11.2022-01.12.2022
Due to the Covid-19 pandemic, we recommend checking the following website for the most recent updates
https://corona.health.gov.il/en/directives/air-travel-covid19-israel/

Staff Week

Staff week ?

The date for staff week are : (27.11.2022)-(01.12.2022), if you can't come choose the option "No".

Personal Details

Salutation:

Gender

First Name:

Last Name:

Phone (include country code):

Email:

Country of Citizenship:

Passport Number

Please upload a short CV:

Please upload a short CV

Upload a digital photograph (JPG)

Home University Information

Home University:

University Location (Country) :

Role title:

Role type:

Job Responsability:

Visit Information-Staff week

Type of Mobility

Visit Information

Type of Mobility

As defined by your International Office

Fields of interest at BGU:

Planned activities and expectations:

Host Information

Do you have a host at BGU ?

Host Salutation:

Host Gender

Host First Name:

Host Last Name

Host Email:

Host Department :

Host Information

Do you have a host at BGU ?

Host Salutation:

Host Gender

Host First Name:

Host Last Name

Host Email:

Host Department :

Planned Dates

From (DD/MM/YYYY):

Until (DD/MM/YYYY):

Planned Dates

From (DD/MM/YYYY):

Until (DD/MM/YYYY):

Home University International Office Contact Details

Please complete the information of the contact person at your university's international office

Representative's Gender

Representative's First Name:

Representative's Last Name

Representative's Role:

Representative's Email:

Representative's phone number (Include country code):

Previous Visits at BGU

Have you previously visited BGU?

Was one of the visits in the framework of Erasmus mobility?

Host First Name:

Host Last Name:

Host Email:

Host Department at BGU:

Last visit month:

please state your last visit dates in BGU

Last visit Year:

I hereby give Ben-Gurion University of the Negev permission to use my likeness in subsequent brochures, posts, videos and other publications.

If checked No but you appear in a group photo, can we use it?

I agree to receive additional information from BGU with respect to the program of interest listed above. Only relevant information will be sent to you. Your contact details provided above will be stored on BGU's databases and will be used only for the above-mentioned purposes

By submitting this form you acknowledge that you have read and agreed to BGU’s Privacy Policy and further confirm that the information that relates to third parties is provided after you informed such third paries of BGU's Privacy Policy and obtained their consent to provide such information.

Contact Information

Staff Week Application 27.11.2022-01.12.2022

Staff Week dates are 27.11.2022-01.12.2022Due to the Covid-19 pandemic, we recommend checking the following website for the most recent updateshttps://corona.health.gov.il/en/directives/air-travel-covid19-israel/

Staff Week dates are 27.11.2022-01.12.2022
Due to the Covid-19 pandemic, we recommend checking the following website for the most recent updates
https://corona.health.gov.il/en/directives/air-travel-covid19-israel/