YVC Application – Machon Chana

Yeshivacation Registration Form

Please fill out the form carefully as it enables us to design a program of study tailored to each individual student’s needs and requests.
* Please have the following prepared: A recent digital photograph of yourself; Conversion papers (if relevant), and the Payment.
** 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, and, if needed, financial aid.

"*" indicates required fields

I. Personal Information

Which session are you registering for?*

Name*

First Last

Hebrew Name

Address*

Street Address City / Postal Code State / Province / Region Country

Phone*

Date of Birth*

Email*

Enter Email Confirm Email

Emergency Contact Name*

First Last

Emergency Contact Phone*

Emergency Contact Relationship*

Highest Grade Completed*

Profession*

Current Ocupation*

What is your primary language?*

What other languages do you speak?*

II. General Information

Why are you interested in learning at Yeshivacation?

What are you hoping to gain from this program?

Please tell us any additional information you think we should know about you.

III. Jewish Background

Are you Jewish?*

Are you a convert to Judaism?

Documents of Conversion

Max. file size: 32 MB.

What is your most positive Jewish experience?

What is your most negative Jewish experience?

What is your general view of the Lubavitch movement?

Jewish Contact/Referral #1

First Last

Rabbi, Shliach, or a head of a Jewish organization that knows you well

Jewish Contact/Referral #1 Phone

Jewish Contact/Referral #1 Email

Jewish Contact/Referral #1 Relationship to you

Jewish Contact/Referral #2 Name

First Last

Rabbi, Shliach, or a head of a Jewish organization that knows you well

Jewish Contact/Referral #2 Phone

Jewish Contact/Referral #2 Email

Jewish Contact/Referral #1 Relationship to you

Upload a recent photo of yourself*

(jpg, gif, png)

Max. file size: 32 MB.

Permission to be included in pictures and videos for promotional purposes.*

Join our Email/Newsletter

Newsletter

Summer Yeshivacation Total*

In Person: $1800 Full Course (6weeks)

In Person: $300 Weekly

Online: $150 Weekly

Winter Yeshivacation Total*

In Person: $1000 (Early Bird: Before Dec 1)

In Person: $1200 (10 days program)

Online: $150 Weekly

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Yeshivacation Application

Yeshivacation Registration Form

I. Personal Information

II. General Information

III. Jewish Background