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Workflow Admin
DEPRECATED Usernameaaron
PARENT CRM EID13646
Account Information
DEPRECATED Bochur's Name
Your Bochur's NameYaakov Rockove
Bochur is aNew Student
Bochur EID13598
Your NameRephoel Rockove
Phone Number+18485254247
Email AddressEmail hidden; Javascript is required.
Health Insurance

IT IS MANDATORY THAT EVERY TALMID HAS HEALTH INSURANCE WHILE IN YESHIVA.
You will receive an email with more information about obtaining health insurance, upon submitting this form.

Tuition and PaymentsStandard tuition is $2,300.00 per month.
Scholarship RequestI would like to request a reduced tuition
Requested Monthly Tuition$1,800.00
Confirmed Monthly Tuition$1,800.00
WARNING - Reduced Tuition I understand and agree to the below
You have indicated that you would like to request a reduced tuition. Please note that all tuition reduction requests will be submitted to the Rosh Yeshiva for review and approval. There is no set timeframe for this process and it may impact your son's ability to enter the zman on time.
Payment OptionsCheck
Name on AccountRephoel Rockove
Account TypeChecking
Account Number581370213
Routing Number021202337
Tuition Electronic Debit Consent I have read and confirm understanding of the following:
On the 1st of every English calendar month, Yeshivas Mishkan Shmuel will directly debit the above bank account for the agreed-upon amount of my son's monthly tuition.
Third Party Organization
Other Third Party Organization Name
Tuition Credit Card Consent
Expenses Credit Card Consent I have read and confirm understanding of the following:
Yeshivas Mishkan Shmuel will charge the credit card labeled "Expenses" above at various times for the amount of $300 each, for the periodic Shabbatons on which the Yeshiva takes all enrolled students. Additionally, in the case that my son arrives to yeshiva without medical insurance, the credit card labeled "Expenses" above will be charged for the cost of obtaining a medical insurance policy for him.
Important Documents
Upload Picture of Bochur's PassportUpload Picture of Bochur's Passport
Upload Picture of Bochur's Birth CertificateUpload Picture of Bochur's Birth Certificate
Bochur's Legal NameYaakov Rockove
Bochur's Passport NumberA74411537
Bochur's Date of Birth07/09/2005
Bochur's Passport CountryUSA
Bochur's Passport Issued On18/09/2025
Bochur's Passport Expires On17/09/2035
Does the Bochur Need a Visa?Yes
Upload Picture of Bochur's Valid VisaUpload Picture of Bochur's Valid Visa
Mispar Zehut
Upload Picture of ID with Mispar Zehut
Visa ForMyself
Missing
Visa InformationA Student Visa is typically valid for 2 years. The yeshiva will oversee the Student Visa application process. There is a $200 processing fee.
Father's NameRephoel Rockove
Father's Date of Birth27/02/1982
Are either of the parents Israeli?Neither
Mother's Nameahuva Rockove
Mother's Date of Birth14/03/1985
Mother's Maiden NameAbraham
Tuition Contract StatusAccepted
Entry Notes
Source URLhttps://mishkanshmuel.com/submit-a-workflow-form/?id=5&workflow_parent_entry_id=13603&workflow_hash=b384325399dfc4b2b6750fef8d646e4f&gflow_access_token=eyJpYXQiOjE3NjIzMTMyNzIsImV4cCI6MTc2NDkwNTI3Miwi
Source ID236
Created By (User)Yaakov Rockove