Northwest Yeshiva High School
Parent Application for 2021-2022 School Year
Student's Name
*
First Name
Last Name
Gender
Female
Male
Birth Date
*
-
Month
-
Day
Year
Date Picker Icon
Place of Birth
What Grade will the student be entering during the 2021-2022 School Year?
*
9th
10th
11th
12th
Student's Email
example@example.com
Are you interested in speaking with our Learning Support Specialist?
Yes
No
1st Parent/Guardian Name
*
1st Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
1st Parent/ Guardian Email
*
example@example.com
1st Parent/Guardian Mobile Phone
*
-
Area Code
Phone Number
2nd Parent/Guardian Name
2nd Parent/Guardian Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2nd Parent/Guardian Email
example@example.com
2nd Parent/Guardian Mobile Phone
-
Area Code
Phone Number
Would the parents/guardians prefer separate mailings?
Yes
No
Sibling Information:
Rows
Name
Age
Grade
School Name
Sibling Information:
Rows
Name
Age
Grade
School Name
Family Members Who Have Attended NYHS:
Name of Program, Group, Camp, or Membership and Dates of Attendance/ Membership
*
Why would you like your child to attend NYHS?
*
What are your expectations for your child's high school experience?
*
If there is any additional information that you would like to share with us, please do so here.
*
Submit
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