Application Form - Yeshivas Chofetz Chaim Yerushalayim

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Applicant

Last Name

Legal First Name

Middle Name

Hebrew Name

Name You Are Known By

Full Address

Student Email Address

Home Phone

Student Cell Phone

Date of birth

Place of Birth

Social Security Number

Has Israeli Citizenship?

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Seek Admission

I hereby seek admission to the Rabbinical Seminary of America. I am aware that a student must familiarize himself with, and abide by the rules & regulations of RSA, and that RSA reserves the right to require the withdrawal of any student at any time for any reason it deems sufficient.

I wish to pursue a degree in:

Talmudic Theory and Jurisprudence
Rabbinic Literature and Jewish Studies

I hereby certify that:

I have graduated from high school
I will graduate at the end of this school year

Place Occupation of

Name of High School

High School Phone Number

Upload your two most recent transcripts

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Upload recent photo

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True to my knowledge

I hereby affirm that the information provided in this application is true to the best of my knowledge.

Disclaimer and Acknowledgement

I have read, understood and accept the following information

All students must arrange local medical insurance to cover potential hospitalization, doctor's visits, and medical expenses. Various insurance plans are available in Israel at a relatively low cost. There are plans that the yeshiva recommends and are available to sign up to through the yeshiva office.

It is understood that the responsibility for obtaining and maintaining medical insurance, as well as covering any medical expenses, rests with the student and his parents. The yeshiva will not be held liable for any medical costs.

Enrollment at Yeshivas Chofetz Chaim Yerushalayim is contingent upon satisfactory participation in the yeshiva's schedule (davening, seder, shiur, etc.) and compliance with the yeshiva's rules and regulations. The yeshiva reserves the right to require a student’s withdrawal at its discretion for any reason it deems appropriate.

A student may only attend classes or use any yeshiva facilities, including the dormitory and dining hall, after completing their registration and settling all tuition, room, and board fees with the yeshiva office.

Any deferment or reduction in fees must be explicitly authorized by the yeshiva office.

No transcripts or certificates will be issued unless all outstanding fees have been fully paid.

Signature

Date

Please note: This application is not a guarantee of admission. Admission to RSA and its affiliates is determined by the applicable institutional administration.

Yeshiva Chofetz Chaim Yerushalayim participates in the Study Abroad program of the Rabbinical Seminary of America. RSA is accredited by the Association of Advanced Rabbinic and Talmudic Schools. RSA students at YCCY are able to earn college credits towards a First Talmudic Degree for up to two years at Yeshiva Chofetz Chaim Yerushalayim. Additionally, registered students can apply for federal aid (Pell grant) by completing a FAFSA, and parents may receive a tax credit if eligible (1098 T Form) for tuition fees paid.

Yeshiva Chofetz Chaim Yerushalayim also participates in the Israel Option program of Touro College, 718-535-9385 or 718-535-9365. Please contact Touro directly to find out about their fees, deadlines and about transferring their credits to other universities.

Applicant

Parents' Information

Father

Mother

Student Medical Information

Emergency Contact

Additional Information

Please list all schools attended and years of attendance.