Workflow Admin
Usernamebenritter1
CRM EID16454
Needs FarherNo
Acceptance StatusAccepted
Student Information
Please Upload a Picture of the StudentPlease Upload a Picture of the Student
Student's NameBen Ritter
Student's Date of Birth22/08/2006
Student's Regular Cell Phone Number+15163104469
Student's Current Email AddressEmail hidden; Javascript is required.
Student's Current Home Address578 Buxton Avenue
West Hempstead, NY 11552
United States
Map It
Father's Information
Father's Full NameYitzy Ritter
Cell Phone Number+13475289733
Email AddressEmail hidden; Javascript is required.
OccupationDentist
Mother's Full NameDeena Ritter
Cell Phone Number+13476789040
Email AddressEmail hidden; Javascript is required.
OccupationOffice manager
Parents' StatusMarried
Tuition Payer's NameDeena Ritter
Phone Number+13476789040
Email AddressEmail hidden; Javascript is required.
Past Education
Current YeshivaYeshivat Reishit
Past Yeshivas
  • None
Elementary School

HANC

Current Rosh Yeshiva NameAri Marcus
Current Rosh Yeshiva Phone Number+972524663297
Current Rabbi NameAri Marcus
Phone Number of Current Rabbi+972524663297
Financial Arrangements

Who will be making financial arrangements for the student's tuition?

Siblings
Name Age
Joshua 27
Daniel 24
Harry 16
Special CircumstancesNo
Please describe the student's special circumstances.
Student Rules
Smartphone Policy I have read and accept the smartphone policy.
Bochur Signature
Personal Items I have read and acknowledge confirmation of the personal items policy.
Shabbosim and Trips I have read and acknowledge confirmation of the Shabbosim and trips policy.
Failure to Follow Rules I have read and acknowledge confirmation of the policy regarding failure to follow the rules.
Application Fee
Billing Address578 Buxton Avenue
West Hempstead, NY 11552
United States
Map It
Credit CardVisa
XXXXXXXXXXXX6297
Application FeeApplication Fee, Qty: 1, Price: $150.00
Entry Notes
Source URLhttps://mishkanshmuel.com/application/
Source ID14
Created By (User)Ben Ritter

Add New Student

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

* This form will only create a student CRM record
It will not create a user account for the student to log in *

Name*

Remove Student

Update Student Information