Certifications of studies, and transcript request form
(Please fill out all the necessary details)
A. Personal Details:
Last Name
Previous Last Name
First Name
Student Number / I.D. Number (all 9 digits):
B. Academic details:
Degree
Department
Began studies on
(year)
Graduated on
(year)
Year of
termination of
studies (for those
who didn't graduate)
C. I ask for the following: (please note – all documents are produced in three copies. For each
additional set, there will be a 10 ILS fee).
Documents requested
Price for active
Price for
students. (Fee will be
graduated/students' who
automatically charged
were terminated. (Please
to your account)
read section D to follow)
Master Transcript
*--40 ILS
PhD Transcript
*---
40 ILS
"Non-Degree" Transcript
*---
40 ILS
Continuing Education Unit Transcript
40 ILS
40 ILS
Current Semester Studies verification
---
---
Verification of duration of studies – for
Master
Verification of duration of studies – for
PhD
Other (please specify)
40 ILS
50 ILS
40 ILS
50 ILS
40 ILS
40 ILS
Proof of Eligibility for degree
40 ILS
40 ILS
Copies of Diploma for
40 ILS
40 ILS
Request to send the original diploma via registered airmail for
those who didn't attend the graduation ceremony
20 ILS
Additional requests/remarks:
_____________________________________________________________________________________
Room #200 Churchill Building ,
200 ‫ חדר‬,‫בניין צ'רצ'יל‬
Tel.
04-8292739,2693
'‫טל‬
Fax.
04-829-5635
'‫פקס‬
yaelc@dp.technion.ac.il
Active Students:
*You may see and download your transcript online:
http://www.graduate.technion.ac.il/Eng/Personal_info/Personal_info.asp
using the personal code given to you at time of acceptance. The Transcript is official only if it is
signed with the Graduate School Stamp at the Graduate School's Office.
*An official Studies Certificate (in Hebrew) will be emailed in the beginning of the semester.
**An official Studies Certificate in English may be ordered at: certificate@dp.technion.ac.il
***Proof of eligibility for the degree and a final transcript (in Hebrew) will be produced
automatically at the end of your studies, and will be sent to you address once the degree has
been confirmed.
D. Payment Method:
A charge to your credit card will be made by the Graduate School Office. Please fill out all
the following details. Your request will be processed after confirmation of payment.
Credit Card:
Exp. Date:
CVV :
Number:
Name on card:
I.D.#
E. Please send the documents to:
Address:
Internal Technion mail, to department
Please leave at the Graduate School Office – I will pick them up personally
If you have any questions, please contact Ms. Levana Ben-Shabat, at the Graduate School office:
Phone: 972-(0)4-8292573, Fax: 972-(0)4-8295635, email: levana@dp.technion.ac.il
Date:
Signature ___________________________
_____________________________________________________________________________________
Room #200 Churchill Building ,
200 ‫ חדר‬,‫בניין צ'רצ'יל‬
Tel.
04-8292739,2693
'‫טל‬
Fax.
04-829-5635
'‫פקס‬
yaelc@dp.technion.ac.il