Part Time Application Date* Semester Fall Spring Summer Name* First Hebrew Last 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 Date of Birth* MM slash DD slash YYYY Mother's Hebrew Name* Phone Number (Home, Cell)* Home Cell Are your parents Jewish? Mother Father If mother isn't Jewish, have you converted? Email* Marital Status*SingleMarriedWidow/ DivorcedWhat is your maiden name?What other topics are you interested in?* Describe your level of learning.* Describe your level of observance.* Describe your prior education.* Describe the talents you can contribute to Machon Chana.* In case of emergency, please contact:* Name Cell number Relationship Describe the talents you can contribute to Machon Chana.* Sunday Courses 9:30 Tanya - Rabbi Naftali Silberberg 10:30 Halacha - Rabbi Chaim Raitport 11:30 Chassidus - Rabbi Osher Kravitsky 1:00 Tefillah - Rabbi Shlomo Sternberg 2:00 Parsha - Rabbi Follie Duvob Choose courses you will be taking.Evening Courses Sunday: (7:00) Maamar - Rabbi Shlomo Sternberg (8:00) - Rabbi (9:00) - Rabbi Tuesday: (7:00) Tishrei with the Rebbe - Rabbi Michael Seligson (8:00) - Rabbi (9:00) - Rabbi Thursday: (7:00) - Rabbi (8:00) - Rabbi (9:00) Farbrengen - Rabbi Osher Kravitsky Choose courses you will be taking.Morning Classes (Monday - Thursday) 8:00 (M to Th) Chassidus - Rabbi Shmuel Samuels 10:00 (M,W) Yiddish Sicha - Mrs. Shainy Oster 10:00 (Tu,Th) Haftorah- Mrs. Elky Dubov 11:00 (M to Th) Halacha - Mrs. Chanchie Hendel 12:00 (M,Tu & Th) Yom Tov Al Pi Chassidus - Mrs. Mushky Katzman 12:00 (W) Mishlei - Mrs. Tzameret Borevitz Choose courses you will be taking.Payment Method One time payment Monthly Other: For payment options please e-mail Chanie Chaimson @ info@machonchana.org* Upload a headshot of yourself.Max. file size: 32 MB.
