Machon Chana Application Hub
Seminary
Part Time
Returning Student
Yeshivacation
Online Degree
Dual Degree
Yeshivacation Application
"
*
" indicates required fields
I. Personal Information
Name
*
First
Last
Hebrew Name
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone where you can be reached
*
Email
*
Date of Birth
*
Month
Day
Year
Hebrew Date of Birth
Month
Day
Year
Date of arrival
*
Month
Day
Year
Do you have any special dietary requirements, allergies?
*
Yes
No
If yes, Please provide details
Do you take any medication(s) or allergic to any medication?
*
Yes
No
If yes, Please provide details
Emergency Contact Name
First
Last
Emergency Contact Phone
Emergency Contact Relation
Relationship of Emergency Contact to you
Highest Grade Completed
Some High School
High School
Some College
College
Certificate
BA, BS
MA, MS
PhD
Professional Training
Current Occupation
What is your primary language?
What other languages do you speak?
Please add a picture
*
Max. file size: 128 MB.
II. General Information
Why are you interested in learning at Yeshivacation?
What are you hoping to gain from this program?
*
Please tell us any additional information you feel we should we know:
III. Jewish Background
Describe your level of observance and for how long:
*
Are you a convert to Judaism?
No
Yes
If yes, who was the converting Beth Din?
Please upload your conversion papers
*
Drop files here or
Select files
Max. file size: 128 MB.
What is your most positive and negative Jewish experience?
What is your general view of the Lubavitch movement?
Jewish Contact/Referral #1 Name
*
Rabbis, Shliach, or a head of a Jewish organization that knows you well
Jewish Contact/Referral #1 Phone
*
Jewish Contact Referral #1 Relation
What is your contacts relationship to you?
Jewish Contact/Referral #2 Name
Rabbis, Shliach, or a head of a Jewish organization that knows you well
Jewish Contact/Referral #2 Phone
Jewish Contact Referral #2 Relation
What is your contacts relationship to you?
Join our Email List/Newsletter
Email List
Newsletter
Permission to be included in pictures and videos for promotional purposes.
*
I agree
I don’t agree
What program are you registering for?
*
Winter
Summer
Winter Yeshivacation (Prices 2022)
Early Bird (Until Dec 10th)
Full price
Online
Summer Yeshivacation (Prices 2023)
Early Bird (Until Dec 10th)
Full program (4 weeks)
3 week program includes food and board (Double occupancy)
1 week program includes food and board (Double occupancy)
1 weekend (Friday-Sunday) program Includes food and board (Double occupancy)
Online
Customized Option
Refunds will involve a cost to the applicant (Up to 6%)
*
I understand and accept
Payment Method
*
PayPal Checkout
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
Total
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