Dual Degree Application

Step 1 of 4

A. Personal information:

Student

Name*

First Last

Hebrew name*

Yours Mother’s Hebrew name

Passport*

Number Country issuing passport

Passport expiry date (dd/mm/yyyy)*

US social security number (If applicable)

Date of birth (mm/dd/yyyy)*

Secular Hebrew

Place of birth*

Country City

Home Address*

Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone*

Home Student's cellular

[Country Code] [Area Code] [Telephone Number]

Student's email*

Father

Father's name*

First Last

Work*

Occupation Place of work

Telephone*

Cellular Work

Father's cellular*

Father's email

Family status*

Mother

Name*

Married Maiden name

Work

Occupation Place of work

Telephone*

Cellular Work/home

Mother's email

Family status*

Please upload your recent picture*

Max. file size: 128 MB.

B. Education

1st School*

Name Location From year To year

Grades Reason for change Principal Telephone of Principal

2nd School*

Name Location From year To year

Grades Reason for change Principal Telephone of Principal

1st year of Seminary (if you had)

Name Location From year To year

Principal Telephone of Principal

Languages

Hebrew*

Reading comprehension

Understands a conversation

Speaks

English*

Reading comprehension

Understands a conversation

Speaks

Other

Reading comprehension

Understands a conversation

Speaks

Which other language

D. Personal Questionnaire

Punctuality in class*

How often do you miss classes? Select the option that fits you best

Sociability*

Select the option that fits you best

Why do you want to study in our school?*

What academic skills are you hoping to acquire ?*

What profession would like you practice in the future? Why?*

How do you define a Jewish home?*

Describe your personal interests and hobbies*

Are you interested in acquiring teaching skills?*

Describe your learning level*

I am acquainted with Frum terminology*

I can learn a Sicha on my own*

I can learn a Maamar on my own*

I study Chitas daily with Rashi*

Please submit with this application 3 letters of recommendations from teachers, directors (seminary or high school) and/or employers

Max. file size: 128 MB.

If you are not able to upload the letters of recommendations, please send them to info@machonchana.org.

The application fee is non-refundable*

I understand and accept

Prices*

If you would like to know more about financials aids and Scholarships, please call the office at 718-735-0030

Application Fee*

Price:

Payment Method*