The Moskowitz Prize for Zionism
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The Winners
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Candidacy Submission Form
Form submission deadline by 15th of Shvat 5770, January 29th, 2010
Are you completing the candidacy form for another person?:
Yes
No
Candidates Details
First Name :
Last Name :
Home Address :
Telephone (Home) :
Telephone (Work) :
Telephone (Cellphone) :
Email :
Work Position/Title :
Place of Employment: :
Work Address:
Work Telephone :
In what field do you view your/the candidate's main contribution to Israeli society?
Education
Research
Settlement
Culture
Defense & Security
Other
Short explanation of the reasons for the candidacy:
Maximum 100 words (500 characters)
Detailed reasons for presenting the candidacy:
Maximum 750 words (3,750 characters)
List of References (minimum of three; if you don't have an email address for the References please put in you own email address):
Name of Reference
Tel. 1
Tel. 2
Email
Please copy the the above letters
into the box below
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