School of Rehabilitation - Form 26

"*Required field" required fields indicator

Name

This field is for validation purposes and should be left unchanged.

July 28, 2026

Course Registration Form

Course Name

Location

Full Name*Required field

First Name Last Name

ID Card*Required field

Email*Required field

Residential address*Required field

Residential address City

Mobile phone*Required field

Gender*Required field

Male

Female

Full Name in English*Required field

First Name in English Last Name in English

Date of Birth*Required field

Education

Education (Specify: degree name, other relevant studies if any)*Required field

Workplace Details

Workplace Name*Required field

Marketing Service Type*Required field

Role*Required field

Workplace address

Work phone

Years of Experience in Role*Required field

Years of Experience in Rehabilitation*Required field

Name of the organization you are affiliated with from your workplace

Training Courses at the School of Rehabilitation

If you have completed training at the Rehabilitation School, please specify which training.

In which year

Additional Information

Intervention group that you lead

Is the group led by you or by a "guidance line"?

Number of meetings in the group

Group transfer dates

Start Date

Closing Date

Professional Manager Name

Professional manager's phone

Entrepreneur Name

District Rehabilitation Coordinator

Rehabilitation Training Courses (if applicable)

Training Name

Training Framework

Number of training hours

Human Verification

For any question/issue, please contact:
shikum@ono.ac.il
03-7382218