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Registration: Step 1 from 2

Please Fill and send the following Form:

To: Lousky College
Subject: Application Form

All the fields are required.

Check the selected option at the checkbox:

1. An intensive one-year study program in Israel
2. An intensive two-year study program in Israel

First name: Last name:
Street: City:
Country: P.O.box
E-mail: Home p. number:
Work p. number: Mobile number:
Date of birth: Marital status:
ID number: Current occupation:
Previous education:
 
In order to process your application,
Please attach a registration fee in amount of 490$ for the Intelligence tests and the registration process:
The registration fee are a part of the tuition fee. If the college decides not to accept you to the program, the registration fee will be returned entirety.
 
Credit Card:    
Name on Card:    
Three digits on the back of the card:  
Card number:
Valid until:    
Date: Full Name:
       
     

                                

 
 
 

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