TUITION & OTHER FEES DECLARATION
FOR FOREIGN STUDENTS ONLY
TECHNION
– ISRAEL INSTITUTE OF TECHNOLOGY
1. Preamble
This form is to be filled only by foreign students, i.e. students who intend to study in the Technion and do not
have an Israeli ID and/or Israeli Passport.
2. Declaration
2.1. I, ______________________________________, a ______________ (country) citizen, Passport No.
___________will be enrolled as a student in the Technion – Israel Institute of Technology, beginning in
the _________ (fall/spring) semester of the _______ academic year. My student number is ___________
2.2. I am aware of Technion Tuition and Student Additional Fees of which I am being charged by the Technion,
and shall pay them in full and on time, as long as I am attending the Technion, until graduation or
discontinuation of my studies as approved by the Dean, as applicable.
2.3. I am aware that the charges of Tuition and Student Additional Fees are updated from time to time and it
is my responsibility to check them.
2.4. I am aware that Tuition pays for studies only and does not cover any other items (such as but not limited
to food and board).
2.5. Additional Fees include, but are not limited to:
2.5.1. Student association fees
2.5.2. Security and welfare fees
2.5.3.Dormitory fees, if applicable, as set by the Dormitory main office
2.5.4.Library late fees and other fees
2.5.5.Use of laboratories and materials as applicable
2.6. I am aware that graduation depends also, and among other things, on paying all of my fees and debts to
the Technion on time and in full.
2.7. This declaration is an irrevocable order to the Technion treasurer to deduct any and all fees from any
scholarships or fellowships, if I receive any from the Technion.
2.8. I am aware that the Technion transfers details of all students who attend the Technion regularly to the
Israeli National Insurance Institute (such as name, passport number, address) and I shall have no claims
regarding this issue.
3. Health Insurance
I am aware that no student can be registered at the Technion without adequate health insurance coverage,
which is the student’s responsibility and must be arranged prior to student's arrival at the Technion. I am
aware that upon my arrival at the Technion I will be required to provide the office of Students Accounts
Department with a copy of my insurance policy.*
2
4. Accident Insurance
I am aware that students registered at the Technion should have adequate accident insurance coverage,
which is the student’s responsibility and should be arranged prior to the student’s arrival at the Technion.**
5. I have read clauses 3 and 4 regarding health and accident insurance coverage and agree to the terms. I will
make the necessary arrangements prior to my arrival at the Technion.
6. The Technion will not be held accountable should I fail to have health and accident insurance coverage and /
or should there be any problem with my health and accident insurance coverage.
7. I declare that I am aware of outcomes that may result from not complying with any and all of the terms and
conditions above.
8. I declare that I agree to all terms and conditions above.
_______________________________
_________________________
Signature
Date
Please sign and send this page to the following address:
Name, ______________
Phone No._____________
Students Accounts Department
Fax No. _______________
Address _________________,
Email Address ______________
Technion – Israel Institute of Technology, Technion City, HAIFA, 32000
(if this document is faxed, please make sure to send the original to the above mailing address)
Tips from Students Accounts Department:
*We have found that students are satisfied with insurance arranged through a local insurance agent working with
the Technion (Mr. Amos Gilboa, Phone: 972-3-6386216; Fax: 972-3-6874534; e-mail: mali@yedidim.co.il)
** The Student Association fee which you are asked to pay includes compulsory basic accident insurance, which is
provided by the Student Association during the academic year only. If you intend to arrive at the Technion prior to
the start of the required date or remain beyond the end of the Spring semester, you must arrange for accident
insurance coverage for the period during which you are not covered by the Student Association policy. The basic
coverage provided by the Student Association policy is minimal and includes: 80,000 Shekels for fatal accident; up
to 130,000 Shekels for permanent total disability; 450 Shekels per week (up to one year) for temporary total
disability. We urge you to take out a supplemental policy which will provide more adequate coverage.