EYAHT - Aish HaTorah's College for Women

Application for Admission

DEADLINE FOR SUBMISSION: Students are welcome to commence their studies at any point during a given semester, with two exceptions. The first is the semester from Rosh Chodesh Adar to Pesach (February 14, 2010 - March 29, 2010). No new students will be admitted after Rosh Chodesh Adar. The second is the period running from Elul to Tishrei (August 10, 2010 - September 22, 2010). All students attending in Elul-Tishrei must be present for the entire semester (from Rosh Chodesh Elul until Yom Kippur), and after this semester has begun we will not accept new students until the following semester. The last day to apply for this term is Tuesday, July 27, 2010. *Please note: A non-refundable application fee of $25 is required, in order for your application to be processed. Please click here in order to submit your fee online via our secured server. If you would prefer to mail a check, please send it to: EYAHT, P.O. Box 41124, Jerusalem, ISRAEL 91410.
DATE OF APPLICATION
PERSONAL INFORMATION
	Last Name		First Name
	Middle Name		Hebrew Name
ADDRESS
	Street		City
	State/Province		Zip Code
	Country

	E-mail		Cellular #
	Phone #		Fax #

	Passport #		Driver License #
	Social Security #

	Your Age
	Date of Birth			Year

	Marital Status	Single Married Divorced
If married, your spouse's:
	Name		Occupation
	Religious observance
	Number of Children		Ages of Children

Emergency Contact
	Name		Phone #
	Country of Birth		Citizen of
How did you find out about EYAHT?
REASONS FOR COMING
	Please write a paragraph or two explaining your reasons for coming to EYAHT and what you hope to gain from your studies
FAMILY BACKGROUND
	Parents' Marital Status Married Divorced Other
	Father's Last Name		Father's First Name
	Father's Occupation		Father's Place of Birth

	Father's Address		(if different than your address above)
	Father's Phone #

	Mother's First Name		Mother's Last Name
	Mother's Maiden Name		Mother's Occupation
	Mother's Place of Birth
	Mother's Address		(if different than your address above)
	Mother's Phone #

	Are you an adopted child?		No Yes

	Was your natural mother born Jewish?		Yes No
	If no, please give details.
	Was your natural father born Jewish?		Yes No
	If no, please give details.
	Are you a child of your mother's first marriage?		Yes No

	Have there been any conversions to Judaism in your immediate family? (including yourself, parents, grandparents, great-grandparents)			Yes No
	If yes, was the conversion: Conservative Reform Orthodox
	Were all of your natural maternal and paternal grandparents Jewish at birth?			Yes No
	If no, which ones?
	Have your natural parents been married more than once?			Yes No
	If yes, please give details:
	Have your natural grandparents been married more than once?			Yes No
	If yes, please give details:
	Do you have relatives (including siblings) living in Israel?			Yes No
	If yes, please list their address and relationship
RELIGIOUS BACKGROUND
	Did you ever attend Hebrew Day/Primary School?		Yes No
	If yes, for how long?
	Did you ever attend a religious High/Secondary School?		Yes No
	If yes, please give details.
	Have you ever studied in another seminary or post-secondary Jewish institution?			Yes No
	If yes, please list:
	School
	Address
	Date of Graduation*
	*If you did not graduate, please explain reason for leaving
	Your religious affiliation	Reform Conservative Traditional Orthodox Unaffiliated Other
	If other, please explain
	If Orthodox, for how long?
	Have you ever been involved in any other religion besides Judaism?			Yes No
	If yes, which one(s), to what extent and how long?
	Your congregation name and city
	Name of Rabbi of congregation
	Parents' religious affiliation: Reform Conservative Traditional Orthodox Unaffiliated Other
	If other, please explain
	Parents' congregation name and city
	Are you or have you ever been a member of a Jewish organization?			Yes No
	If yes, please give the name and position held, if any
	Are your parents affiliated with any Jewish organization (e.g., UJA, B'nai B'rith, WZO, etc.)? Yes No
	If yes, please specify organization and position held, if any
EDUCATION
	Name of High/Secondary School
	Location		Dates of Attendance
	Graduated?	Yes No	Graduation date
	List chronologically all your post-secondary education (i.e., colleges, universities or technical schools). In case of large universities, indicate which school or branch:
	• School		• City

	• Course/Major/Minor		• Dates of attendance

	• Graduated?	Yes No
	• Degrees received
	• School
	• City
	• Course/Major/Minor
	• Dates of attendance
	• Graduated?	Yes No
	• Degrees received
	• School
	• City
	• Course/Major/Minor
	• Dates of attendance
	• Graduated?	Yes No
	• Degrees received
	Academic honors or other distinctions you have received in high school and university
	Current occupation or career
JOB HISTORY/VOLUNTEER WORK* [Entries should be in reverse chronological order.]
	• Position		• Business Name
	• City		• Type of Business
	• Employment Dates

	• Position		• Business Name
	• City		• Type of Business
	• Employment Dates

	• Position		• Business Name
	• City		• Type of Business
	• Employment Dates
	*If you've spent time after graduation in activities other than jobs or volunteer work, please explain
GENERAL INFORMATION
	Language Skills:
	• English:	Speaking	Fair Good Fluent
		Understanding Speech	Fair Good Fluent
	• Hebrew:	Speaking	Nonexistent Fair Good Fluent
		Understanding Speech	Nonexistent Fair Good Fluent
		Reading Comprehension	Nonexistent Fair Good Fluent
		Writing	Nonexistent Fair Good Fluent

	List any hobbies, special skills and talents (e.g., artistic, musical, theatrical, technical, athletic, etc.)
	List any extra-curricular activities and organizations you are currently involved in or have been involved in, and describe your participation in them over the last few years
	Are you a vegetarian, or do you have other special dietary needs?			Yes No
	If yes, please list
	Do you have, or have you had, any medical problems (e.g., diabetes, heart condition, epilepsy, bulimia, anorexia, depression, allergies, operations)? Yes No If so, please list
	Have you ever been treated under the care of a psychiatrist?			Yes No
	If yes, please list doctor's name and phone number
	Are you currently taking, or have you ever taken, medication for anxiety or depression? Yes No
	Do you have any physical disabilities?		Yes No
	If yes, please describe
	Do you have any reading disabilities?		Yes No
	If yes, please describe
	Do you have any accessibility requirements?		Yes No
	If yes, please describe
	Have you ever been addicted to any substances?		Yes No
	If yes, please give details
REFERENCES
	Please provide two rabbinical references (including Aish rabbis), along with contact information:
	• Name:		• Address:
	• Phone #:		• E-mail:
	• Relation:

	• Name:		• Address:
	• Phone #:		• E-mail:
	• Relation:
TUITION
	Please Note: 1) A student’s financial obligations to EYAHT must be satisfied with the Administrator (e-mail admissions@eyaht.com for more information). Click here for more information regarding tuition agreement. 2) Full tuition and fees (including room and board) are $700 per month.
	Do you intend to apply for any student loan?			Yes No
	What is your anticipated length of stay at EYAHT?
	Note: Students wishing to enroll at EYAHT for a minimum of three weeks may be eligible to apply for a flight scholarship through the Jeff Seidel AW Scholarship Fund. If you intend to apply for this scholarship, you must click here and fill out a separate application. After submitting your application to EYAHT, you should click on their link if you wish to apply to that Fund.
	When would you like to begin your studies?
	Would you like to study: Full time Part time* (*Part time studies only available for married students.)
	Have you ever taken out, or do you have at present, any outstanding student loans, grants or other financial obligations related to previous education?			Yes No
	If yes, please give details
	Do you wish to defer any student loans from another institution during your time at EYAHT? If yes, e-mail registrar@aish.com immediately upon applying to EYAHT (Note: Loan deferrals are possible only if applicants e-mail registrar@aish.com at the same time as they submit their application to EYAHT. Don't forget to come back and click this link as soon as you've submitted your application!)			Yes No

	Do you intend to use your EYAHT learning toward academic credit in a university?*			Yes No
	(*Tuition arrangements for any courses for which you intend to request transfer credit must be agreed to with the Administrative officer before the course begins.)
ESSAYS
	Please write a brief autobiography
	List the accomplishments of which you are most proud
HEALTH INSURANCE
	NOTE: EYAHT CARRIES NO MEDICAL OR HOSPITALIZATION INSURANCE WHATSOEVER FOR ITS DORMITORY OR OTHER STUDENTS. THUS, ALL STUDENTS ARE SOLELY RESPONSIBLE TO PROCURE THEIR OWN MEDICAL AND HOSPITALIZATION INSURANCE TO COVER ALL OF THEIR HEALTH CARE NEEDS. ANY PERSON WHO IS NOT COVERED BY PRIVATELY PROCURED MEDICAL AND HOSPITALIZATION INSURANCE IS STRONGLY ADVISED TO PROCURE SUCH INSURANCE PRIOR TO ENROLLING AT EYAHT. IN AN EFFORT TO SERVE ITS STUDENTS, EYAHT HAS ARRANGED FOR THE AVAILABILITY OF FULL MEDICAL COVERAGE AND HOSPITALIZATION-ONLY COVERAGE THROUGH THE SHILOACH INSURANCE COMPANY. A STUDENT WISHING TO REGISTER WITH EITHER INSURANCE COVERAGE MUST MAKE APPROPRIATE ARRANGEMENTS AND MUST BEAR THE FULL EXPENSE. REGISTRATION IS HIGHLY RECOMMENDED. DETAILS AS TO HOW TO REGISTER, BENEFITS INCLUDED AND COSTS CAN BE OBTAINED FROM MRS. RIVKA LEAH WOLF
ACKNOWLEDGEMENT OF NOTICE AND WAIVER
	I have read the above notice and understand that EYAHT, the Aish HaTorah College of Jewish Studies for Women, carries no medical or hospitalization insurance whatsoever for its dormitory or other students, and that all students are solely responsible to procure their own medical and hospitalization insurance to cover all their health care needs. Name Date I release EYAHT, the Aish HaTorah College of Jewish Studies for Women, from any obligation to provide health insurance coverage for my health or medical benefits. I alone shall assume full financial responsibility for any health care charges, bills or expenses incurred during my enrollment at EYAHT, the Aish HaTorah College of Jewish Studies for Women, except to the extent that such charges, bills or expenses are covered by insurance that I have privately procured. (Name, Date) Name Date
APPLICANT CERTIFICATION
	An application certification, verifying that all information supplied in this application is correct and complete, must be signed as part of the enrollment process. Upon acceptance to EYAHT, new students will be sent the necessary documentation for their signature.
*Please note: A non-refundable application fee of $25 is required, in order for your application to be processed. Please click here in order to submit your fee online via our secured server. If you would prefer to mail a check, please send it to: EYAHT, P.O. Box 41124, Jerusalem, ISRAEL 91410.