Part Time Application "*" indicates required fields Name* First Hebrew Last Mother's Hebrew Name* Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Semester*FallSpringSummerPhone Number (Home, Cell)* Home Cell Date of Birth* MM slash DD slash YYYY Marital Status*SingleMarriedWidow/ DivorcedAre your parent’s Jewish*MotherFatherConvertedEmail* What other topics are you interested in?* Describe your level of learning.* Describe your level of observance.* Describe your prior education.* In case of emergency, please contact:* Name Cell number Relationship Sunday Courses 9:30 Tanya - Rabbi Naftali Silberberg 10:30 Hilchos Purim/Pesach - Rabbi Shmuel Samuels 11:30 Gemarah - Rabbi YY Barber 1:00 Klalei Chinuch v'Hadracha - Rabbi Shlomo Sternberg 2:00 Minhagei Chasunah - Mrs. Rivka Holzman Choose courses you will be taking.Evening Courses Sunday: (6:50) Avodas Hamidos in Chassidus - Rabbi Shlomo Sternberg (7:50) Drushai Chasuna - Rabbi Levke Kaplan (8:40-9:30) Rashi Sichos - Rabbi Yosef Meijers Tuesday: (6:50) Halacha - Rabbi Yitzchok Dubov (7:45) Jewish Home - Mrs. Mariasha Djian (8:40) Torah Ohr on Parsha - Rabbi Moshe Kaplan Wednesday: (6:45) Marriage Relationship - Mrs. Aber (7:50) Maamar Samach Vov - Rabbi Yosef Meijers (8:40) Shaar HaBitachon - Mrs. Chaya Tzukernik Thursday: (6:50) Da Ma L'Hashiv - Rabbi Yitzchok Dubov (7:45) Yoma D'Pagra/Megillah - Rabbi Michoel Seligson (8:40) Farbrengen - Rabbi Osher Kravitsky Choose courses you will be taking.Morning Classes (Monday - Thursday) 8:15-9:15 (M-Th) Chassidus - Rabbi Shmuel Samuels 10:00 (M) Chassidus on Parsha - Rabbi Yitzchok Dubov 10:00 (Tu) Sicha - Mrs. Shainy Oster 10:00 (W) Jewish Home - Mrs. Sara Junik 10:00 (Th) Chassidus on Parsha - Rabbi Yitzchok Dubov 11:00 (M) Jewish Home - Mrs. Sara Labkowski 11:00 (Tu) The Rebbe's Opinion - Mrs. Mushky Katzman 11:00 (W) Parsha Insights - Mrs. Tzameret Borevitz 11:00 (Th) Chumash - Mrs. Chana Landa 12:00 (M,W,Th) Halacha - Rabbi YY Barber 12:00 (Tu) Moshiach U'Geulah - Rabbi Levi Garelick Choose courses you will be taking.Payment Method One time payment Monthly Other: Refunds will involve a cost to the applicant (Up to 3%)* I understand and accept For payment options please e-mail Chanie Chaimson @ info@machonchana.org* Upload a headshot of yourself.*Max. file size: 32 MB.
