| Workflow Admin | |||||
| Username | nathann | ||||
| CRM EID | 16451 | ||||
| Needs Farher | No | ||||
| Acceptance Status | Pending Acceptance | ||||
| Student Information | |||||
| Please Upload a Picture of the Student | ![]() | ||||
| Student's Name | Nathan Dovid Nussbaum | ||||
| Student's Date of Birth | 08/03/2006 | ||||
| Student's Regular Cell Phone Number | +17023034925 | ||||
| Student's Current Email Address | Email hidden; Javascript is required. | ||||
| Student's Current Home Address | 201 w 79th street New York, NY 10024 United States Map It | ||||
| Father's Information | |||||
| Father's Full Name | N/A N/A | ||||
| Cell Phone Number | +19736344714 | ||||
| Email Address | Email hidden; Javascript is required. | ||||
| Occupation | NA | ||||
| Mother's Full Name | Susan Nussbaum | ||||
| Cell Phone Number | +19736344714 | ||||
| Email Address | Email hidden; Javascript is required. | ||||
| Occupation | Charity owner | ||||
| Parents' Status | Father deceased | ||||
| Tuition Payer's Name | Susan Nussbaum | ||||
| Phone Number | +19736344714 | ||||
| Email Address | Email hidden; Javascript is required. | ||||
| Past Education | |||||
| Current Yeshiva | Reishit | ||||
| Past Yeshivas |
| ||||
| Elementary School | Kushner | ||||
| Current Rosh Yeshiva Name | Rav Ari Marcus Ari Marcus | ||||
| Current Rosh Yeshiva Phone Number | +972524663297 | ||||
| Current Rabbi Name | Rav aryeh freidman Aryeh freidman | ||||
| Phone Number of Current Rabbi | +972553298785 | ||||
| Financial Arrangements | Who will be making financial arrangements for the student's tuition? | ||||
| Siblings |
| ||||
| Special Circumstances | No | ||||
| 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 Address | 201 w 79th street New York, NY 10024 United States Map It | ||||
| Credit Card | Visa XXXXXXXXXXXX1029 | ||||
| Application Fee | Application Fee, Qty: 1, Price: $150.00 | ||||
| Entry Notes | |||||
| Source URL | https://mishkanshmuel.com/application/ | ||||
| Source ID | 14 | ||||
| Created By (User) | Nathan Nussbaum |
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I have read and accept the smartphone policy.