Application- 2

Applicant Information

Name*

First Middle Last

Hebrew Name*

Informal Name*

Date of Birth*

Phone*

Home Address

Street Address City State / Province / Region ZIP / Postal Code Country

Is the mailing address the same as the home address?*

Yes

No

Mailing Address:*

Street Address City State / Province / Region ZIP / Postal Code Country

I am a:*

US Citizen

Permanent Resident

Other

Social Security #*

Previous Education

Are you a High School Graduate?*

Yes

No

List chronologically all the High Schools\Mesiftos you have attended*

Name of school

Location

Dates of Attendance

Graduation Date

Have you ever attended a post-secondary institution?*

Yes

No

(include Bais Medrash, college, and post-secondary vocational programs)

List chronologically all the post-secondary institutions you have attended*

Name of school

Location

Dates of Attendance

Degree Awarded

I hereby apply for enrollment as a regular student at Yeshiva Zichron Aryeh for the purpose of obtaining a First Talmudic Degree. I certify that all the information contained on this application is accurate and complete to the best of my knowledge. I further understand that I must remain in compliance of all of Yeshiva Zichron Aryeh rules and regulations as described in the catalog and other official notices and publications.

Father/Guardian Information

Father's Name*

First Last

Mother's Name*

First Last

Father's Occupation

Mother's Occupation

Father's Cell

Mother's Cell

Father's Email

Mother's Email

Marital Status

Single

Married

Wife's Name

Paternal Grandparents Name

First Last

Paternal Grandparents Telephone

Email

Paternal Grandparents Address

Street Address City State / Province / Region ZIP / Postal Code

Maternal Grandparents Name

First Last

Maternal Grandparents Telephone

Email

Maternal Grandparents Address

Street Address City State / Province / Region ZIP / Postal Code

PLEASE ENCLOSE PROOF OF HIGH SCHOOL GRADUATION OR COMPLETION WITH YOUR APPLICATION (A copy of your diploma, transcripts or a letter from the graduating school will suffice)

PLEASE ENCLOSE A COPY OF INSURANCE CARD AND PROOF OF IMMUNIZATION WITH APPLICATION

Does the Applicant have any medical conditions that may affect him while attending Yeshiva?

Medical Insurance company

Blood type

Name of your last Rebbe:

Phone

How many daily Gemora Sedorim were in your last Yeshiva program

How long was each one?

Evaluate your past year’s learning including hasmodo, leining ability and general progress

Will you be attending college while in Yeshiva?

Yes

No

Which one?

What is your major?

Expected date of graduation

List all part-time or full-time jobs you have held in the past two years

How has the Applicant spent the last three summers

What factors were involved in the Applicant’s decision to apply to our Yeshiva? Explain

Who referred you to Zichron Aryeh?

Tuition

The following is the fee schedule for the school year:
Tuition-$19,800.00
Registration -$500.00
Total -$20,300

Please check appropriately:*

I will be paying the full tuition of $20,300.00, if my son is accepted and enrolled in Yeshiva Ohr Hatzafon.

I will not be able to pay the full tuition and would like to request a scholarship if my son is accepted and enrolled in Yeshiva Ohr Hatzafon.

I would like a scholarship of $

I would pay a total of $*

Scholarship availability will be determined by the tuition committee.

PLEASE NOTE: In order to continue the enrollment process, this form MUST be received by the Yeshiva. The enrollment process will be considered complete and the student will be permitted to attend ONLY after the Yeshiva receives all of the required forms and payments as per the enrollment contract

Application Form 2024

Applicant Information

Previous Education

Father/Guardian Information

Tuition