Chaya Aydel Seminary Hallandale, Florida Personal Information First Name Last Name Street Address City, State, Zip Home Phone Cell Phone Fax # Email Birthday Secular Birthday Family Information Fathers Name Rabbi Dr. Mr. Mothers Name Fathers Cell Mothers Cell Fathers Email Mothes Email Applicant Details Current School Address School Phone School Fax Previous School Have you applied elsehwere? yes no If yes, where? Summer Experiences (location, shliach) Summer 1 Phone Summer 2 Phone References (Please attach two letters of recommendation) 1. Name Phone Position How long have you known this person? 2. Name Phone Position How long have you known this person? Please number in order of importance to you (1=most important, 4=less important) 1 2 3 4 Academic Program 1 2 3 4 Chassidishe Environment/Farbrengen 1 2 3 Social Experience 1 2 3 4 Community Involvement Please use this space to describe what is most important to you in a seminary. Please describe how you envision your year in seminary. What are some of your concerns about seminary? List two (2) of your favorite limudei kodesh subjects, and why you enjoy them. Please share any health concerns you might have. Please share any allergy or eating concerns. What or who motivated you to apply to the Chaya Aydel Seminary? Submit a $100 non refundable registration fee First Name* Last Name* Address* (Please use the address associated with the credit card you will be using.) City* State* Zip Code* Phone E-mail Method Credit Card Number* Expires* (mmyy) CVV Security code # This page uses 128 bit SSL encryption to keep your data secure.
