| Workflow Admin | |||||||||||
| Username | yonigoldberg | ||||||||||
| CRM EID | 16591 | ||||||||||
| Needs Farher | No | ||||||||||
| Acceptance Status | Pending Acceptance | ||||||||||
| Student Information | |||||||||||
| Please Upload a Picture of the Student | |||||||||||
| Student's Name | Yoni Goldberg | ||||||||||
| Student's Date of Birth | 27/07/2006 | ||||||||||
| Student's Regular Cell Phone Number | +447939035040 | ||||||||||
| Student's Current Email Address | Email hidden; Javascript is required. | ||||||||||
| Student's Current Home Address | 2 Cranbourne Gardens London, London NW110HP United Kingdom Map It | ||||||||||
| Father's Information | |||||||||||
| Father's Full Name | Doniel Goldberg | ||||||||||
| Cell Phone Number | +447779231287 | ||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||
| Occupation | Businessman - Company Director | ||||||||||
| Mother's Full Name | Ora Goldberg | ||||||||||
| Cell Phone Number | +447734824768 | ||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||
| Occupation | Woman's Educator | ||||||||||
| Parents' Status | Married | ||||||||||
| Tuition Payer's Name | Doniel Goldberg | ||||||||||
| Phone Number | +447779231287 | ||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||
| Past Education | |||||||||||
| Current Yeshiva | Toras Moshe | ||||||||||
| Past Yeshivas |
| ||||||||||
| Elementary School | Menorah Grammer School | ||||||||||
| Current Rosh Yeshiva Name | Naftali Meiselman | ||||||||||
| Current Rosh Yeshiva Phone Number | +972527635835 | ||||||||||
| Current Rabbi Name | Avromi Heckscher | ||||||||||
| Phone Number of Current Rabbi | +447534518559 | ||||||||||
| Financial Arrangements | Who will be making financial arrangements for the student's tuition? | ||||||||||
| Siblings |
| ||||||||||
| Special Circumstances | Yes | ||||||||||
| Please describe the student's special circumstances. | Add – medicated with Attent 20 mg. Has had coaching and therapy | ||||||||||
| 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 | 2 Cranbourne Gardens London, London NW110HP United Kingdom Map It | ||||||||||
| Credit Card | Visa XXXXXXXXXXXX9565 | ||||||||||
| Application Fee | Application Fee, Qty: 1, Price: $150.00 | ||||||||||
| Entry Notes | |||||||||||
| Source URL | https://mishkanshmuel.com/application/ | ||||||||||
| Source ID | 14 | ||||||||||
| Created By (User) | Yoni Goldberg |
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I have read and accept the smartphone policy.