YBDS Mesivta 5787 - Shiur Alef Application Form

YBDS Mesivta Shiur Alef Application - WAITLIST

Application Status

Last Name*

Name Bochur Prefers*

Legal Name*

Full Hebrew Name*

Birthday*

MonthDayYear

Hebrew Birthday*

Age*

Allergies*

Daily Medications*

YesNo (please contact the office before continuing application)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone Number

YesNo - (please contact the office before continuing your application)

MarriedDivorcedSeparatedWidowed

Both ParentsFatherMother

Father's Name*

Father's Hebrew Name*

Father's Email Address*

Father's Cell Phone Number*

Father's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Father's Work Name / Occupation*

Father's Hebrew Education*

Mother's Name*

Mother's Hebrew Name*

Mother's Maiden Name*

Mother's Email Address*

Mother's Cell Phone Number*

Mother's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mother's Work Name / Occupation*

Mother's Hebrew Education*

Current School 5786/25-26*

Current Grade 5786/25-26*

School Name 5786/ 2025-2026

Primary Teacher*

Phone number*

Principal*

School Attended 5785/24-25*

Grade 5785/24-25*

School Name 5785/ 2024-2025

Primary Teacher*

Phone Number*

Principal*

Camp attended Summer 2025*

Counselor*

Learning Teacher*

Camp attended Summer 2024*

Learning Teacher*

Counselor*

1) Acceptance by principal.

2) Abiding with Yeshiva regulations.

3) YBDS may require the withdrawal of a student at any time, for any reason it deems necessary.

4) Tuition payments must be made as agreed upon and on a timely basis.

5) Providing YBDS with the necessary information and documentation to enable the Yeshiva to obtain scholarship funds where applicable.

6) Authorizing my son(s) to participate in all school trips.

7) Authorizing YBDS to make all decisions concerning emergency medical treatment.

8) Providing YBDS with the name and policy numbers of my son’s medical insurance and/or purchasing additional insurance when necessary.

9) Accepting the responsibility for any medical expenses incurred on behalf of my son(s).

10) Agreement that any dispute with YBDS, for any reason, will be decided on by hearing and adjudication by a Beis Din in accordance with Jewish law.

11) Giving up all rights to have such disputes heard in a civil court trial. Further, I waive the right of appeal from the decision of the Beis
Din.

I accept all the conditions as indicated above - Please type first and last name to acknowledge your consent:*

• Tuition: (All fees are in U.S. Dollars)

• Registration Fee: $250.00

• Mesivta and Dormitory: $19,055

Upon acceptance, the first month's tuition must be paid. All payments need to be set up within 2 weeks of acceptance to keep your space.

• Mikvah Fee: $180 (separate check made out to Mikvas Moshe)

• Summer Program: $3,605

• Activity Fee: $824

* A 3% discount will be given to payments made via check/cash

• Tuition must be paid in full even if a talmid leaves Yeshivas Beis Dovid Shlomo regardless of the reason, before the end of the school year.

• Tuition: (All fees are in U.S. Dollars)

• Registration Fee: $250.00 - only due if space opens

• Mesivta and Dormitory: $19,055

Upon acceptance, the first month's tuition must be paid. All payments need to be set up within 2 weeks of acceptance to keep your space.

• Mikvah Fee: $180 (separate check made out to Mikvas Moshe)

• Summer Program: $3,605

• Activity Fee: $824

* A 3% discount will be given to payments made via check/cash

• Tuition must be paid in full even if a talmid leaves Yeshivas Beis Dovid Shlomo regardless of the reason, before the end of the school year.

Registration Fee $250 - to be paid via Link Below

My Products*

YBDS Shiur Alef Application Payment

$250.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Date

YBDS Mesivta 5787 - Shiur Alef Application Form

STUDENT INFORMATION

PARENT INFORMATION

SCHOOL INFORMATION

SUMMER PROGRAM INFORMATION

Admission to Yeshivas Beis Dovid Shlomo is subject to the following conditions:

TUITION INFORMATION

Registration Fee