| Workflow Admin | |||||||||||||||
| Username | mordechai | ||||||||||||||
| CRM EID | 16563 | ||||||||||||||
| Needs Farher | No | ||||||||||||||
| Acceptance Status | Pending Acceptance | ||||||||||||||
| Student Information | |||||||||||||||
| Please Upload a Picture of the Student | SPChoppMordechai.pdf | ||||||||||||||
| Student's Name | Mordechai Chopp | ||||||||||||||
| Student's Date of Birth | 14/01/2005 | ||||||||||||||
| Student's Regular Cell Phone Number | +13475246871 | ||||||||||||||
| Student's Current Email Address | Email hidden; Javascript is required. | ||||||||||||||
| Student's Current Home Address | 123 brick church rd spring valley, ny 10977 United States Map It | ||||||||||||||
| Father's Information | |||||||||||||||
| Father's Full Name | Shlomo chopp | ||||||||||||||
| Cell Phone Number | +13479920493 | ||||||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||||||
| Occupation | real estate | ||||||||||||||
| Mother's Full Name | adina chopp | ||||||||||||||
| Cell Phone Number | +13479621348 | ||||||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||||||
| Occupation | homemaker | ||||||||||||||
| Parents' Status | Married | ||||||||||||||
| Tuition Payer's Name | Shlomo chopp | ||||||||||||||
| Phone Number | +13479920493 | ||||||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||||||
| Past Education | |||||||||||||||
| Current Yeshiva | yeshivas Torah Vadaath | ||||||||||||||
| Past Yeshivas |
| ||||||||||||||
| Elementary School | Yeshiva of Spring Valley | ||||||||||||||
| Current Rosh Yeshiva Name | Yitzchak Abba lichtenstein | ||||||||||||||
| Current Rosh Yeshiva Phone Number | +18456087430 | ||||||||||||||
| Current Rabbi Name | Yitzchok abba Lichtenstein | ||||||||||||||
| Phone Number of Current Rabbi | +18456087430 | ||||||||||||||
| 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 | 123 brick church rd spring valley, ny 10977 United States Map It | ||||||||||||||
| Credit Card | American Express XXXXXXXXXXX2007 | ||||||||||||||
| Application Fee | Application Fee, Qty: 1, Price: $150.00 | ||||||||||||||
| Entry Notes | |||||||||||||||
| Source URL | https://mishkanshmuel.com/application/ | ||||||||||||||
| Source ID | 14 | ||||||||||||||
| Created By (User) | Mordechai Chopp |
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