Application Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
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Hebrew Birthday
English Birthday
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Family Information
Father's Name
*
First Name
Last Name
Father Cell Phone#
*
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Father's Email
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example@example.com
Mother's Name
*
First Name
Last Name
Mother's Cell Phone#
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Mother's Email
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example@example.com
Applicant's Details
Current School
*
School Phone #
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School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you applied to other seminaries?
*
Please Select
Yes
No
If yes, where?
Summer Experience #1
Please include the location and name of the shluchim
Shluchim Phone #
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Summer Experience #2
Please include the location and name of the shluchim
Shluchims Phone #
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References
Reference Name #1
*
First Name
Last Name
Position/Relationship to you
*
How long have you known this person?
*
Phone Number
*
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Reference Name #2
*
First Name
Last Name
Position/Relationship to you
*
How long have you known this person?
*
Phone Number
*
Please enter a valid phone number.
Please upload two letters of recommendation
*
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Academic Program
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2
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4
Social Experience
*
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1
2
3
4
Chassidishe Environment/Farbrengen
*
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1
2
3
4
Community Involvement
*
Please Select
1
2
3
4
Please use this space to describe what is most important to you in a seminary.
*
Please describe how you envision your year in seminary.
*
What are some of your concerns about seminary?
List two (2) of your favorite limudei kodesh subjects, and why you enjoy them.
*
Please share any health concerns you might have.
*
Please share any allergy or eating concerns.
*
What or who motivated you to apply to the Chaya Aydel Seminary?
*
Please submit your application fee below:
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Application Fee
$
100.00
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