Note: Please fill out the form for each participant separately

Personal Information:

First Name:

Last Name

Date of Birth:

(DD/MM/YYYY)

Country of Birth

Mobile Number:

Please provide your mobile number without country code.

E-Mail

Complete Address:

Street:

City

Postcode

Country

Are you a doctor or medical student?

Field of Occupation

Occupation

Years of Experience

Marital Status

Occupation Id

Number of Children under 18

Field of Occupation ID

Are you planning to attend the event with your spouse/partner/Child over 18?

First Name:

Last Name:

Date of Birth

(DD/MM/YYYY)

Mobile Number:

E-Mail

Profession

Medical Specialty

If you are filling out the form on your desktop computer, please hold down the Ctrl button to select multiple values. If you are using a mobile phone, each selected value is saved..

Medical Subspecialty

If you are filling out the form on your desktop computer, please hold down the Ctrl button to select multiple values. If you are using a mobile phone, each selected value is saved.

Do you plan on presenting documentation at MedEx UK for your Israeli medical license?

We are exploring offering the Yael Hebrew exam at MedEx UK. As you may know, from June 2027, doctors will be required to complete a Hebrew requirement in order to get a license (requirement already exists for those entering the staj lottery). The exam is 1.5 hours. If this is an option at MedEx UK, are you interested in taking the Yael test?

Approximate Aliyah Date

(DD/MM/YYYY)

Gender

Israeli Status, if any

Country of Study (if not UK)

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Profession NBN ID

Occupation Field JAFI ID

Profession JAFI ID

How did you hear about this event?

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I agree that to the best of my knowledge I am eligible for Aliyah under the Law of Return. I also give permission to share my information with the Jewish Agency for Israel, Ministry of Aliyah and Integration, Ministry of Health, and potential employers in Israel.

I would like to hear about other programs and projects from the Jewish Agency, its subsidiaries or partners (Nefesh B'Nefesh,etc).

Information will be shared with other parties for the purpose of providing a service related to the employment process and needs, in accordance with the Jewish Agency and Nefesh B'Nefesh Privacy Policy

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EventSession ID

Country

Office

Start date

Start time

Profession old:

Status:

Marketing fields

Campaign Name

Campaign Source

Campaign Content

Campaign Term

Source

Campaign Medium