The Palmach House
June 2012
Personal Data Form of the Palmach Members
A. Personal Data:
First Name _______________________ Surname _______________________________
Former Surname ____________________ Nickname ______________________________
Father's name ______________________ Mother's name ___________________________
Date of Birth (year, month, day) ________________Wife/Husband's name______________
Place of Birth (Town, State) ___________________________________________________
Date of Immigration to Israel, place of departure ___________________________________
______________________________ Army Personal number ________________________
Full Address (street, house, zip code, town, state) ___________________________________
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Phone no. _____________________ E-Mail: ______________________________________
B. Activities in the Palmach:
Date of Mobilization to the Palmach (month, year) ___________________________________
Formation/Hachshara ____________________ Platoon _____________________________
Regiment/Brigade ____________________________________________________________
Your Main Jobs in the Palmach (job, date, place, unit – if possible) _______________________
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Main Activities & Operations you Participated in (1941-1949)
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C. Your Main Activities and Jobs in I.D.F. (Zahal), if any:
___________________________________________________________________________
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D. Your Civil Jobs/Occupations/Education/Publications:
___________________________________________________________________________
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You can write in your own words and add as many separate sheets of your life story, as you need.
Also, you can send pictures, documents and books related to your Palmach time.
Date: __________________
Signature: _________________
Please send to: Dr. Eldad Harouvi, Palmach House, 10 Lebanon St. POB 65080, Tel-Aviv, Israel
61650. E-Mail: harouvi.eldad@gmail.com; The Palmach website: www.palmach.org.il