HIGH SCHOOL APPLICATION

HIGH SCHOOL APPLICATION

996 Haverstraw Road
Suffern NY, 10901
(845)-538-4125
Fax: (845)547-2156
Info@Tiferet.us
APPLICATION FOR ADMISSION
For School Year
Grade
Name *

First Name Last Name

Home address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Date of birth *

Month Day Year
Date Date Picker Icon
Home Telephone

Area Code Phone Number
Father’s name
Occupation
Business Telephone

Area Code Phone Number
Cell#

Area Code Phone Number
E-mail
Mother’s name
Maiden name
Occupation
Cell #

Area Code Phone Number
Email
example@example.com
Parents are:

Married Divorced Separated Deceased
Other children in family

Yes No
Number of Sisters
Number of brothers
Name of Yeshiva presently attending

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Telephone

Area Code Phone Number
Hebrew grade
Rebbi’s name
Rebbi's phone number
Menahel's Name
Menahel Phone number
List Yeshivot previously attended:
Name of Yeshivot
Years attended:
PERSONAL AND BACKGROUND INFORMATION:
List of Msechtot learned in the previous two years:
What subjects do you like best?
What subjects do you find most difficult?
What is your ambition?
Have you ever had any serious illness (specify)?
Are you presently (or recently) taking any medication?
Do you have any physical handicaps?
Summer camps attended
Shul family attends
Rabbi’s name
Rabbi's phone number
How did you hear of Tiferet Torah?
Parents’ remarks or comments
Please upload a most recent picture *

Browse Files

Cancel of

Application Fee

USD Application Fee

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Please have form below filled out by the current Menahel, and send back to Info@Tiferet.us
I hereby certify that the above information is complete and accurate.
Should be Empty: