Application

An interview is required for all applicants. If you have not already had an interview, we will be in contact with you to arrange one.
Non-applicable questions should be marked N/A.
Please include a current photo when submitting your application.
Application must be signed to be considered for acceptance.
Please ensure the applicant’s details and not a parent’s are entered in the section marked Applicant Information. A parent’s email address entered instead of the applicants will cause errors in processing the application.
All fields marked with an * are compulsory.

Applying for Academic Year*
Applying for Academic Year*
-*
Applicant Information
Name*
First Middle Last
Legal Name as on Passport:*
Hebrew Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Applicant's Cell Phone*
Home Phone*
Applicant's Email*
Date of Birth*
Country of Birth*
Passport Number*
Passport Expiration*
MM slash DD slash YYYY
Country of Issue*
Do you have Israeli citizenship?*
- Yes
- No
Do you have an Israeli passport?*
- Yes
- No
Education
Elementary School- Name & Location
Elementary School- From Year to Year (20xx-20xx)
High School- Name & Location*
High School- From Year to Year (20xx-20xx)*
Current Rebbe's Name & Email or Phone Number*
Mesechta you are currently learning*
Additional school
- Have an additional school?
Additional School #1- Name & Location
Additional School #1- From Year to Year (20xx-20xx)
Additional School #2- Name & Location
Additional School #2- From Year to Year (20xx-20xx)
Summer Camp Attended the Past Two Summers*
First Summer Camp*
Second Summer Camp*
Father Information
Name*
Title First Last
Marital Status*
Date of Birth*
For visa purposes we will need your parents’ dates of birth
Father- Address*
(if different than the applicant's)

Street Address City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell Phone*
Email*
Occupation*
Citizenship*
Has Israeli citizenship?*
- Yes
- No
Mother Information
Name*
Title First Last
Maiden Name
Marital Status*
Date of Birth*
For visa purposes we will need your parents’ dates of birth
Mother- Address*
(if different than the applicant's)

Street Address City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell Phone*
Email*
Occupation*
Citizenship*
Has Israeli citizenship?*
- Yes
- No
Siblings
Number of Siblings
Sibling1- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling2- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling3- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling4- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling5- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling6- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling7- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling8- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling9- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling10- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling11- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling12- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling13- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling14- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Sibling15- Name
Name & Age School/Occupation Yeshiva Attended in Israel (if applicable)
Family in Israel
Family In Israel #1- Name
Name Relationship
Address
Street Address City
Home Phone
Cell Phone
Additional family in Israel
- Have another family in Israel?
Family In Israel #2- Name
Name Relationship
Address
Street Address City
Home Phone
Cell Phone
Medical Information
Do you have any allergies or special dietary requirements?*
Please list any medications you are currently taking and for what.*
Is there anything else medically that we should be aware of?*
Name of Emergency Contact in Israel #1
First Last
Address
Street Address City
Home Phone
Cell Phone
Relationship
Additional emergency contact in Israel
- Have an additional emergency contact in Israel?
Name of Emergency Contact in Israel #2
First Last
Address
Street Address City
Home Phone
Cell Phone
Relationship
Disclaimer and Signature
1. The yeshiva requires all students to insure themselves with local coverage in case of hospitalization or other medical expenses. There are different policies available in Israel, which will cover the student either for hospitalization and/or doctor's visits at a relatively small cost. The most efficient coverage is through Israeli insurance plans made available through the yeshiva.
2. It is understood that the responsibility of medical insurance and hospitalization is upon the student and the parents. Under no circumstances will the yeshiva be responsible for the student's medical expenses. Tuition fees do not cover medical expenses or insurance.
3. The privilege of studying at Yeshivas Bais Yisroel, is conditional on satisfactory participation in all sedarim and shiurim, and on adherence to the rules and regulations of the yeshiva. The yeshiva reserves the right to require the withdrawal of any student according to its conditions, for any reason it deems sufficient.
4. An applicant will only be accepted as a student and privileged to participate in classes or utilize any of the facilities including the dormitory and dining room, after he has completed his registration and settled all matters of fees for tuition, room and board with the yeshiva office.
5. Deferment or reduction in payment of fees will only be considered valid when authorized by the yeshiva office.
6. No transcript or certificate will be issued without full payment of outstanding fees.
Upload Photo*
Max. file size: 100 MB.
Confirmation*
- I have carefully read all of the above information, and hereby certify that all the information provided on this form is true, accurate and complete to the best of my knowledge.
Date*
Privacy*
- I accept the Privacy Policy. *
Email
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Applicant Information

Education

Father Information

Mother Information

Siblings

Family in Israel

Medical Information

Disclaimer and Signature