Part Time Application – Machon Chana Application Hub

Name*

First Hebrew Last

Mother's Hebrew Name*

Address*

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

Semester*

Phone Number (Home, Cell)*

Home Cell

Date of Birth*

Marital Status*

Are your parent’s Jewish*

Please upload your conversion papers*

Drop files here or

Max. file size: 128 MB.

Email*

What other topics are you interested in?*

Describe your level of learning.*

Describe your level of observance.*

Describe your prior education.*

In case of emergency, please contact:*

Name Cell number Relationship

Sunday Courses

9:00 Davening – Mrs. Miri Cohen

9:30 Derech Mitzvosecha – Mrs. Chaya Miriam Klein

10:30 Avoda on Yom Kippur – Rabbi Shmuel Aber

11:30 Machzor – Rabbi Levi Garelik

12:30 Halacha – Rabbi Sholom Shuchat

Choose courses you will be taking.

Evening Courses – will be updated soon

Choose courses you will be taking.

Morning Classes (Monday – Thursday)

Choose courses you will be taking.

Are you planning to take the classes online?*

Yes

Upload a headshot of yourself.*

Max. file size: 128 MB.

Registration Fee*

I understand and accept

The registration fee is non-refundable

Total

Payment Method*