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| Workflow Admin | |||||||||
| Username | aviglatstein | ||||||||
| CRM EID | 16997 | ||||||||
| Needs Farher | Yes | ||||||||
| Acceptance Status | Accepted | ||||||||
| Student Information | |||||||||
| Please Upload a Picture of the Student |  | ||||||||
| Student's Name | Avi GLATSTEIN | ||||||||
| Student's Date of Birth | 20/11/2004 | ||||||||
| Student's Regular Cell Phone Number | +18482452322 | ||||||||
| Student's Current Email Address | Email hidden; Javascript is required. | ||||||||
| Student's Current Home Address | 341 Case Road Lakewood, New Jersey 08701 United States Map It | ||||||||
| Father's Information | |||||||||
| Father's Full Name | Isaac (Yitzchak) Glatstein | ||||||||
| Cell Phone Number | +16178771121 | ||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||
| Occupation | Physician | ||||||||
| Mother's Full Name | Gitty Glatstein | ||||||||
| Cell Phone Number | +16177339772 | ||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||
| Occupation | Marketing | ||||||||
| Parents' Status | Married | ||||||||
| Tuition Payer's Name | Isaac (Yitzchak) Glatstein | ||||||||
| Phone Number | +16178771121 | ||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||
| Past Education | |||||||||
| Current Yeshiva | Yeshiva Kerem Shlomo | ||||||||
| Past Yeshivas |
| ||||||||
| Elementary School | Yeshiva Tiferes Torah | ||||||||
| Current Rosh Yeshiva Name | Tzvi Menachem Feigenbaum | ||||||||
| Current Rosh Yeshiva Phone Number | +19086000104 | ||||||||
| Current Rabbi Name | Tzvi Menachem Feigenbaum | ||||||||
| Phone Number of Current Rabbi | +19086000104 | ||||||||
| 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 | 341 Case Road Lakewood, New Jersey 08701 United States Map It | ||||||||
| Credit Card | American Express XXXXXXXXXXX7004 | ||||||||
| Application Fee | Application Fee, Qty: 1, Price: $150.00 | ||||||||
| Entry Notes | |||||||||
| Source URL | https://mishkanshmuel.com/application/ | ||||||||
| Source ID | 14 | ||||||||
| Created By (User) | Avi GLATSTEIN |
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