Application

Basic requirements

Applicants to Machon Chana’s full-time Yeshiva Program must have a High School Diploma and be proficient in the English language.

1. Application: please have the following information prepared

An essay describing your motivation for applying to Machon Chana, your personal goals for Machon Chana and how you intend to fulfill them (approximately 500 words);
Contact information (email & phone) for two references (rabbi, professor, employer, etc.);
A recent digital photograph of yourself;
Conversion papers to upload (if relevant).

2. Interview

Upon receipt of the completed application, an in-person or phone interview will be scheduled. At the interview, students will receive further information regarding classes, housing, job opportunities and, if needed, financial aid. Please call 917- 473- 2826 between 11 am till 3 pm to schedule an interview.

3. Tuition Fees

Upon completion of your application process, including submission of all forms and your interview, you will receive an email from the tuition committee. We are committed to working out tuition arrangements for our accepted students. No accepted student has ever been turned away for financial reasons. Scholarships and Work-study opportunities.

Registrations Fees are 100$

Please pay now and write your name at checkout. Further payment will be scheduled with the office.

5. Medical Form

Please print, fill this out, have your doctor sign it and return to us by email (registrations@machonchana.org) – Medical Form.

Returning students

Before beginning this process please be in touch, email us to Registrations@machonchana.org, or call at (718) 735-0030. Typically we ask returning students to prepare the following:

An essay describing your accomplishments at Machon Chana and your personal goals for the upcoming year and how you intend to fulfill them (approximately 500 words);
Updated contact information;
A recent digital photograph of yourself.

Machon Chana Seminary Application

To apply for Machon Chana programs, please fill out this four part form. Thank you! After filling this Application form, please call 347- 200- 0632 between 11 am till 3 pm (NY time) to schedule an interview (if you are not able to participate in a face to face interview, a skype interview can be set up).

Step 1 of 6

I. Personal Background
Program Applying for*
Arrival Date*
MM slash DD slash YYYY

When would you like to begin your studies? (could be approximate date)
Title
Name*
First Last
Hebrew Name*

Please enter "no" if you don't have
Current Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Home Phone*
Mobile Phone*
Email*
Enter Email Confirm Email
Country of Citizenship*
Social Security/ Passport Number*
Age*
Place of Birth*
City State / Province Country
Date of Birth*
Month
Day
Year
Marital Status*
- Single
- Married
- Divorced
- Separated
- Widowed
Maiden Name
Permanent Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Is there anyone else living at this address?*
Name Relation to you
Occupation*
- Studying
- Studying and working
- Working
Employer Name*
First Last
Employer Phone Number*
Father/ Legal Guardian Name*
First Last
His Hebrew Name*

Please enter "no" if he doesn't have
Father's Address
Street Address City State / Province / Region ZIP / Postal Code Country

Please enter the address if different than yours
His Phone Number*
His Email*
Mother/ Legal Guardian Name*
First Last
Her Hebrew Name*
First Last

Please enter "no" if she doesn't have
Mother's Address
Street Address City State / Province / Region ZIP / Postal Code Country

Please enter the address if different than yours
Her Phone Number*
Her Email*
Was your mother born Jewish?*
Please upload your mother's or your conversion papers
Max. file size: 32 MB.
Please upload your recent picture*
Max. file size: 32 MB.

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References
Please submit two references, including a rabbi or rebbetzin and, preferably, a Jewish community/ campus leader or someone who knows you well. Please list the people who will be submitting references on your behalf and DETAILED letters of recommendation written on the business or personal letterhead of the person submitting the letter.
First Jewish Contact/ Reference*
Name Relation to you Phone Number Email
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Upload First Reference
Max. file size: 32 MB.
Second Jewish Contact/ Reference*
Name Relation to you Phone Number Email
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Upload Second Reference
Max. file size: 32 MB.
Application Objective
How long do you plan to attend Machon Chana?*
- One term
- One year
- Two years
- Summer (yeshivacation)
- Winter Break (yeshivacation)
Why do you want to learn at Machon Chana, and what are your goals for attending the school?*
Will you need accommodations while studying at Machon Chana?*
- Yes
- No
Please explain why*
How or from whom did you hear about Machon Chana?*

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IV. Medical Form
All information will remain strictly confidential and will only be used by medical providers in case of medical necessity while the student is in school. Students with pre-existing health conditions must have medical insurance/coverage or proof of ability to pay for any necessary medical treatment and medication. If there is a medical condition that affects one’s attendance of classes, she will need to return home to care for her health. By signing this form you agree to pay for any costs associated with health care that may not be covered by your insurance should the staff determine you are in need of such.
Name of Student*
Date of Birth*
Month
Day
Year
In case of emergency contact:*
Name Relation to you
Emergency Contact Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Emergency Contact Phone Number*
1. Do you have any special dietary requirements?*
If yes, Please provide details
2. Do you now or have you ever suffered from an eating disorder?*
If yes, Please provide details
3. Have you ever received psychological counseling?*
If yes, Please provide details
4. Do you suffer from any mental or emotional illnesses?*
If yes, Please provide details
5. Do you suffer from any allergies?*
If yes, Please provide details
Please indicate allergies to medications as well
6. Do you suffer from asthma, eczema or hives?*
If yes, Please provide details
7. Do you suffer from any of the following?*
- Tuberculosis
- Epilepsy
- Heart diseases
- Respiratory illnesses
- Diabetes
- Digestive tract diseases (such as chronic constipation or diarrhea)
- Any other significant illness
- None
If yes, Please provide details
8. Did you have any hospitalizations and surgeries in the past?*
If yes, Please provide details
Month/Year Length of Hospitalization Diagnosis
9. Do you have any physical limitations?*
If yes, Please provide details
10. Do you take any medication(s)?*
If yes, Please list name of medication(s) and reason for use
11. Are you allergic to any medication(s)?*
If yes, Please provide details
Is it there any other information regarding your health which you feel we should know about?
*
- I have read the above and affirm that all information contained on this application is true and accurate to the best of my knowledge. Falsifying or purposefully leaving out any information on this medical form is cause for immediate expulsion from the school and dorm, as well as cancellation of the student visa in case of foreign students. If there is medical information that a prospective student deems extremely confidential and does not wish to write on this for it must be discussed orally with Mrs Labkowski.
Signature
Applicant's Signature*

Please re-enter your full name
Date*
MM slash DD slash YYYY
Parent/ Guardian Signature

(If applicant is under 18 years of age)

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Name of Institution	Address	Program attended (e.g. day school, Talmud Torah, Yeshiva)	Affiliation (e.g. Reform)	Length of Time attended

Name of Institution (e.g. university, vocational school)	Address	Major, Field of Study, Curriculum	Status (e.g. B.A., Master's, current student)	Date Completed

Company Name	City, State, Country	Job Title or Position Held	Date Job Started	Date Job Ended

Name of Organization or Group	City, State, Country	Job Title or Position AND Brief Description of Activities	Date Active from	Date Active to

Basic requirements

1. Application: please have the following information prepared

2. Interview

3. Tuition Fees

5. Medical Form

Returning students

Machon Chana Seminary Application

Step 1 of 6

I. Personal Background

References

Application Objective

II. Education, Jobs, and Activities

III. Jewish Affiliation, Background, and Knowledge

Level of knowledge

Foreign Students

IV. Medical Form

V. Payment Information

Month/Year	Length of Hospitalization	Diagnosis

Hello!

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Application

Basic requirements

1. Application: please have the following information prepared

2. Interview

3. Tuition Fees

5. Medical Form

Returning students

Machon Chana Seminary Application

Step 1 of 6

I. Personal Background

References

Application Objective

II. Education, Jobs, and Activities

III. Jewish Affiliation, Background, and Knowledge

Level of knowledge

Foreign Students

IV. Medical Form

V. Payment Information