New Student School Form

To be completed by student's current school. The completed form must be received in order to process the application for admission.

Today's Date*
MM slash DD slash YYYY
Student Name*
First Middle Last
Parent/Guardian Name
First Last
School Name*
School Phone*
School Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Menahel/Person Completing the Form*
Name Position Phone Email
Dear Menahel
Please attach a copy of the student’s report card and achievement test scores for the last two years (Limudei Kodesh and Limudei Chol) and transcript (if applicable). In addition, please complete the form below. For any questions please feel free to contact Rabbi Yisroel Meir Rosenman at 845-641-8601. Your assistance is greatly appreciated.
1. I have included*
- Hebrew Report Cards for the last two years
- English Report Cards for the last two years
- Transcript
Upload Multiple Files*
Drop files here or

Max. file size: 64 MB.
2. Assessment of Character*
Please use a scale of 1 (lowest) to 5 (highest)
Integrity Behavior Effort Following instructions Dealing with fellow students Readiness for higher learning
3. Assessment of Capabilities - Limudei Kodesh*
Please use a scale of 1 (lowest) to 5 (highest)
Iyun Bekius Chumash and Rashi TaNaCh Halacha Mussar and Hashkafa
4. Assessment of Capabilities - Limudei Chol/Secular Studies*
Please use a scale of 1 (lowest) to 5 (highest)
English composition Grammar Math Science Social studies
5. Please list any special student services the student has received*
You can add as many lines as you need. If question does not apply, please write “n/a” or “none.”
6. Please recommend special student services you feel the student should receive*
You can add as many lines as you need. If question does not apply, please write “n/a” or “none.”
7. Please provide additional information that may be beneficial for determining an appropriate placement for the student*
Signature of Menahel
Name
This field is for validation purposes and should be left unchanged.

New Student School Form

NEW STUDENT SCHOOL FORM

Dear Menahel