Ben-Gurion University of the Negev
Security Department

Email: kapel@bgu.ac.il, Tel: 08-6472501/2, Fax: 08-6472911 	
Details of Visitor - For Overseas Travelers	
Dear Visiting Fellow
 In order to facilitate and assist in security check at Ben – Gurion Airport, the "Details of Visitor" form must be submitted manually to the Security Department at least one week prior the date of travel.	
Important Instructions:
1.	Parts a-j must be filled by Principal Investigator in readable and clear handwriting.
2.	Part k must be filled by Visiting Fellow in readable and clear handwriting.
3.	Once the approval document is granted to the Visiting Fellow by the security department of Ben – Gurion Airport (via the security department of Ben – Gurion University), it is the Visiting Fellow's responsibility to maintain this document and present it, along with passport, at the first security check at Ben – Gurion Airport.
4.	Spouse and Children over the age of 15, whom are traveling with Visiting Fellow, must fill out this form as well (one form for each traveler) and submit it to the security department of Ben – Gurion University. They must follow instructions 1-3.	
a) Visiting Fellow’s Name  	
Source of Name	Surname	First name	
			
b) Flight and Destination Details (in case of a connection flight, please fill in details regarding the flight leaving Israel)	
Destination 	Flight No. 	Airline	Flight Date (Departure)	
			
__ __/__ __/______
  Day  /Month/  Year	
Date of Birth	Nationality	Passport No.	
__ __/__ __/_______
 Day /Month/  Year										
Additional Passport No.	Additional Passport (mark the appropriate box)	

Yes, Country: _____________         No	
c) Workplace Details	
Purpose of Visit	Occupation/Position	Visitor's University/Company Name	
			
Visit Coordinator	Financier of Visit	Initiator of Visit	
			
d) Accommodation Details		
Hotel Reservation (abroad)	
Duration of Stay	Address	Name of Hotel/Residence	
Date____________  To Date____________			
Date_____________  To Date_____________			
Date_____________  To Date_____________			
Period of acquaintance between principal investigator and visiting fellow (please mention the relevant number and time unit – Days/Weeks/Months/Years. For example: 5 years):  ___________  	
Visit Schedule (fill in the name/s of the city/ies, country/ies and date/s of visit during your travel abroad) 	
Duration of  Stay	City & Country	
From_______________ To______________		
From_______________ To______________		
From_______________ To______________		
Lodging in Israel	
Duration of Stay	Address	Name of Hotel/Residence	
Date____________  To Date____________			
Date_____________  To Date___________			
Date_____________  To Date___________			
Days Off (fill in the time period, starting the date which the visiting fellow has completed his/her research period until his/her date of departure of Israel): ___________	
e) Visitor's Escort Details		
Mobile No.	Phone No. (Office/Home)	Full Name	
			
f) Additional Details 	
	1. Additional Contacts in Israel (Business, Private):	
	2. Did the visitor get any gifts or souvenirs from his/her Principal Investigator or Ben Gurion University (such as a pen, shirt, hat, etc)?  	
	3. Was the visitor in contact with any explosive materials regarding his/her work (in labs, research centers, etc)? 	
g) Details of the Arrival (in case of a connection flight, please fill in details regarding the flight coming to your last destination)	
Name of Country - Final Destination 	Flight No. 	Airline	Flight Date 	
			
__ __/__ __/_______
  Day /Month/ Year	
h) Comments	
____________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________	
i) Contact Information of Principal Investigator   	
Fax No.	Mobile No.	Phone No. (Office/Home)	Full Name	
				
j) Declaration of Principal Investigator	
I declare and confirm that the details contained in this form were filled by me and I take full responsibility regarding the correctness of the details above.
	
Date	Signature	Full Name	
			
k) Declaration of Visiting Fellow	
I declare and confirm that the details contained in this form are correct.	
Date	Signature	Full Name