Part Time Application

Part Time Application

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Name*
Address*
Phone Number (Home, Cell)*
MM slash DD slash YYYY
In case of emergency, please contact:*
Sunday Courses
Choose courses you will be taking.
Evening Courses
Choose courses you will be taking.
Morning Classes (Monday - Thursday)
Choose courses you will be taking.
Max. file size: 32 MB.
Payment Information*
Please e-mail Chanie Chaimson info@machonchana.org for the total price of the courses and for payment options
The registration fee is non-refundable
Payment Method
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa