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Applicant's Medical Information

Allergies

Medicine

Medical statements will not be accepted without an official signature or stamp. JPG, PNG or PDF


Other Health and Medical Information

Payment of the $50 registration fee

The options for payment are:

Paypal – go into www.em-is.org and use the paypal button (can use Paypal or credit card). Must add 3% paypal fee.

or

Bank transfer:

Bank Hapoalim 12

Ramat Hasharon Branch 630

Sokolov 90, Ramat Hsharon

Account number 16437

Name: Hakfar Hayarok Ltd.

Swift code: POALILIT

Clearing-house code: IL012630

IBAN: IL91-0126-3000-0000-0016-437

or

Credit Card To pay via Credit Card, please navigate to the our school’s website www.em-is.org and click the “Donate” button in the lower of the home page:

(Make sure to charge transfer costs to your account).

Please email us the conformation of the transaction: accounts@em-is.org.

Please write your application no. on the transaction.

For each of these payment options, please select ‘Bank Transfer’ when submitting this form