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The Overseas Student Program of Ben Gurion University's Electronic Payment Form



   

Student Information

Please provide your information.

First Name*
Last Name*
Gender*
Date of Birth*
Address Line 1*
Address Line 2
City*
State
Zip
Country*
Phone Number 1*
Phone Number 2
Email Address 1*
Email Address 2
Program*
Year*

Pay To
Pay ToPayment DuePay Amount
Application Fee $60.00   $

   

Late Application fee $100.00   $

   

Confirmation Deposit (goes towards tuition) $250.00   $

   

Ulpan 4 weeks $985.00   $

   

Ulpan 6 weeks $1,615.00   $

   

Ulpan W/Semester $1,500.00   $

   

Semester Tuition $6,950.00   $

   

Year Tuition $10,950.00   $

   

Dormitory 4 weeks $350.00   $

   

Dormitory 6 weeks $525.00   $

   

Dormitory Semester (with Ulpan) $1,900.00   $

   

Dormitory Year (with Ulpan) $3,500.00   $

   

Transcript $15.00 (per transcript) $15.00   $

   

Total: $  0.00


Payment Method & Account Information

Please provide your payment type and payment account information.

Effective Payment Date 4/17/2014
E-mail Address*



* Required field



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