5. Country of birth (as per current boundaries) and year of immigration
[] 1. Born in Israel
Father's country of birth:
[] 1. Israel
[] 2. Ukraine
[] 3. Morocco
[] 4. Iraq
[] 5. Poland
[] 6. Rumania
[] 7. Yemen
[] Other country, please specify ____
Mother's country of birth:
[] 1. Israel
[] 2. Ukraine
[] 3. Morocco
[] 4. Iraq
[] 5. Poland
[] 6. Rumania
[] 7. Yemen
[] Other country, please specify ____
[] 2. Born abroad
Year of immigration: 19 _ _
Country of birth:
[] 2. Ukraine
[] 3. Morocco
[] 4. Iraq
[] 5. Poland
[] 6. Rumania
[] 7. Yemen
[] Other country, please specify ____