Personal Information
First Name
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Last Name
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Hebrew Name
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Date of Birth
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Permanent Address
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Permanent City
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Permanent State
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Permanent Zip
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Permanent Country
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Permanent Phone
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Permanent Cell
*
Email
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Nationality
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Passport /Israeli ID Number
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Date Of Aliyah ( Discounts are available for Israeli residents with a teudat zehut card.)
Jewish Background
Family Religion
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Father Jewish
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Yes
No
Mother Jewish
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Yes
No
If you converted: Date of Conversion
Beth Din
Marital Status
*
Single
Married
Divorced
Widowed
Spouse Name (If relevant)
Number of Children
Present Occupation
*
Place of Work
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Position
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Education
High School Education
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Year Graduated
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City
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College Education
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Year Graduated
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Major
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City
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Jewish Education/Seminary
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Year Graduated
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Address
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What synagogue or minyan do you attend?
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Rabbi
*
City
*
Please provide us with a name and contact information of someone who can provide a personal reference for you
Name
*
Email
*
Phone
*
Summer Program
Period of Study
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Full time
Half time
Part time
Are you applying for space in the Nishmat dormitory (for Full Time students only)
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Yes
No
Have you ever lived away from home before?
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Yes
No
Enter Years
Summer Camp
College
Abroad
Independently
Where Did You Hear About the Program
*
Website
Alumnae
Staff
Facebook
Instagram
Other
If Other, please specify
If you are studying full time, meals are included. Please choose:
Meat
Vegetarian
Gluten Free
Do you have any dietary restrictions/food allergies?
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Yes
No
If yes, please elaborate
If you are styding Part Time, would you like to join our meal plan for an added fee?
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Yes
No
Medical Information (Confidential):
Do you have medical conditions that affect your study at Nishmat?
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Yes
No
If yes, please specify
Are you taking any medications
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Yes
No
If yes, please specify
?Are you under the care of a doctor
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Yes
No
If yes, please specify
Are you receiving mental health counseling
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Yes
No
If yes, please specify
Are you receiving Psychiatric care?
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Yes
No
If yes, please specify
Study Background
Hebrew Comprehension
*
I cannot follow a class in Hebrew
I have limited understanding
I can follow a class in Hebrew
I understand Hebrew fluently
Read Hebrew
*
I cannot read Hebrew
I read Hebrew with vowels
I can read Hebrew without vowels
I read Hebrew fluently
Reading/ understanding text of Tanach
*
No prior experience
Limited prior experience
Capable of independent study
Advanced
Reading/ understanding Rashi on Tanach
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No prior experience
Limited prior experience
Capable of independent study
Advanced
Did you learn Gemara before?
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Yes
No
At what level did you learn Gemara
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Basic
Advanced
Essay Questions:
Summarize your personal Jewish history, including significant changes in your sttitude toward Judaism, and your current practice of Halacha.
*
What do you hope to gain by studying at Nishmat?
*
Please send a headshot to
[email protected]
*
Please submit your application fee through the link that will appear upon submission of this form.
Your application will be reviewed only once we have received your payment. Application fee total $50 Note: Application fee will be deducted from the tuition cost
Submit