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Workflow Admin
DEPRECATED Usernamefathertest
PARENT CRM EID771
Account Information
DEPRECATED Bochur's Name
Your Bochur's Nametest test
Bochur is aNew Student
Bochur EID427
Your NameFather Test
Phone Number+19178094315
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$1,300.00
Confirmed Monthly Tuition$1,300.00
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 OptionsThird Party
Name on Account
Account Type
Account Number
Routing Number
Tuition Electronic Debit Consent
Third Party OrganizationFidelity Charitable
Other Third Party Organization Name
Tuition Credit Card Consent
Expenses Credit Card Consent
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 NameStudent Test
Bochur's Passport Number123456789
Bochur's Date of Birth04/06/2024
Bochur's Passport Countryusa
Bochur's Passport Issued On03/06/2024
Bochur's Passport Expires On14/06/2024
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 Name
Father's Date of Birth
Are either of the parents Israeli?
Mother's Name
Mother's Date of Birth
Mother's Maiden Name
Tuition Contract StatusAccepted
Entry Notes
Source URLhttps://mishkanshmuel.com/tuition/?id=5&workflow_parent_entry_id=727&workflow_hash=5e799cf7e941dcd34ad3e5fc9f06c386
Source ID
Created By (User)Father Test