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.

I. Personal Information
Which session are you registering for?*
Name*
First Last
Hebrew Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Date of Birth*
Year
Year
Year
Emergency Contact Name*
First Last
Emergency Contact Phone
Emergency Contact Relationship

Relationship of Emergency Contact to you
Highest Grade Completed*
Professional Training
Current Occupation
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
- Email
- Newsletter
Summer Yeshivacation Total
- In Person: $1500 Full Course (6weeks)
- In Person: $300 Weekly
- Online: $150 Weekly

Save and Continue Later

Yeshivacation Registration Form

I. Personal Information
Which session are you registering for?*
Name*
First Last
Hebrew Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Date of Birth*
Year
Year
Year
Emergency Contact Name*
First Last
Emergency Contact Phone
Emergency Contact Relationship

Relationship of Emergency Contact to you
Highest Grade Completed*
Professional Training
Current Occupation
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
- Email
- Newsletter
Summer Yeshivacation Total
- In Person: $1500 Full Course (6weeks)
- In Person: $300 Weekly
- Online: $150 Weekly

Save and Continue Later

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Yeshivacation Registration Form

I. Personal Information

II. General Information

III. Jewish Background

Yeshivacation Registration Form

I. Personal Information

II. General Information

III. Jewish Background