Course Registration Form

Yeshivat Shaarei Talmud Registration

Fill out the form carefully for registration
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Student Mobile Number (optional)
Format: (000) 000-0000.
Father's name
Father's email
Father's mobile number
Father's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's name
Mother's email
Mother's mobile number
Mother's Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current School
Current Principal
Synagogue affiliation (if any)
Additional Comments
Upon registration, contact will be through email or text.

At that time we will request the transcripts and report cards from 8th grade and above as well as medical forms and emergency contact information.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
We believe that every student has unique strengths and tremendous potential.

Our goal is to help each talmid develop a genuine connection to Torah and Mitzvot while gaining the skills, discipline, and maturity needed for life.
NOTICE OF NONDISCRIMINATORY POLICY AS TO STUDENTS
Yeshivat Shaarei Talmud admits Jewish students of any race, coIor, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school
administered program.
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Yeshivat Shaarei Talmud Registration