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| Workflow Admin | |||||||||||||||||||
| Username | yshulman | ||||||||||||||||||
| CRM EID | 2089 | ||||||||||||||||||
| Needs Farher | No | ||||||||||||||||||
| Acceptance Status | Accepted | ||||||||||||||||||
| Student Information | |||||||||||||||||||
| Please Upload a Picture of the Student | ![]() | ||||||||||||||||||
| Student's Name | Motty Shulman | ||||||||||||||||||
| Student's Date of Birth | 21/01/2004 | ||||||||||||||||||
| Student's Regular Cell Phone Number | +18456416474 | ||||||||||||||||||
| Student's Current Email Address | Email hidden; Javascript is required. | ||||||||||||||||||
| Student's Current Home Address | 5 Woodwind Lane Spring Valley, NY 10977 United States Map It | ||||||||||||||||||
| Father's Information | |||||||||||||||||||
| Father's Full Name | Motty Shulman | ||||||||||||||||||
| Cell Phone Number | +18456413567 | ||||||||||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||||||||||
| Occupation | Attorney | ||||||||||||||||||
| Mother's Full Name | Rivka Shulman | ||||||||||||||||||
| Cell Phone Number | +18456428291 | ||||||||||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||||||||||
| Occupation | N/A | ||||||||||||||||||
| Parents' Status | Married | ||||||||||||||||||
| Tuition Payer's Name | Motty Shulman | ||||||||||||||||||
| Phone Number | +18456413567 | ||||||||||||||||||
| Email Address | Email hidden; Javascript is required. | ||||||||||||||||||
| Past Education | |||||||||||||||||||
| Current Yeshiva | Bais Medrash Toras Chesed (Stein's) | ||||||||||||||||||
| Past Yeshivas |
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| Elementary School | Yeshiva of Spring Valley | ||||||||||||||||||
| Current Rosh Yeshiva Name | HaRav Nosson Stein | ||||||||||||||||||
| Current Rosh Yeshiva Phone Number | +17323677308 | ||||||||||||||||||
| Current Rabbi Name | HaRav Nosson Stein | ||||||||||||||||||
| Phone Number of Current Rabbi | +17323677308 | ||||||||||||||||||
| Financial Arrangements | Who will be making financial arrangements for the student's tuition? | ||||||||||||||||||
| Siblings |
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| 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 following policy: | ||||||||||||||||||
| Shabbosim and Trips | I have read and acknowledge confirmation of the following policy: | ||||||||||||||||||
| Failure to Follow Rules | I have read and acknowledge confirmation of the following policy: | ||||||||||||||||||
| Application Fee | |||||||||||||||||||
| Billing Address | 5 Woodwind Lane Spring Valley, NY 10977 United States Map It | ||||||||||||||||||
| Credit Card | Visa XXXXXXXXXXXX7248 | ||||||||||||||||||
| Application Fee | Application Fee, Qty: 1, Price: $150.00 | ||||||||||||||||||
| Entry Notes | |||||||||||||||||||
| Source URL | https://mishkanshmuel.com/application/ | ||||||||||||||||||
| Source ID | |||||||||||||||||||
| Created By (User) | Yehuda Shulman |
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I have read and accept the smartphone policy.