Complete the following form and submit it with the send button at the bottom of the form.
The form must be completed for each 'project request use' of the Large Scale Facility.

Rehovot 76100, Israel. Phone: 972-8-9343897, Fax: 972-8-9344128
e.mail: roberta.tsabary@weizmann.ac.il


  • Last name
  • First name
  • Title
  • Age
  • Gender
  • Nationality
  • Researcher's Scientific Status
  • Researcher's Country
    of affiliation
  • Group Leader
Name: Title:
  • Group Leader's Country
    of affiliation
  • Group Leader's Email
  • Institute/Organization
  • Institute's Status
  • Address
  • Telephone
  • Email
  • Fax
  • Tentative visit time
From (dd/mm/yy)   Until (dd/mm/yy)   
  • Comments
Title and description of project and expected outcome of visit:
Projects must not include work already funded by other EU programs.
  • Project Title
  • A Detailed Project Description
    (minimum half a page)
  • References