Application
Applications are due November 30, 2017.

Please fill out the application below.

1. In order for all applications to be processed, a non-refundable $250 application fee must be submitted.
Please use the "Buy Now" button below.
2. Please email a picture of your son to the admissions office - admissions@heichalhatorah.org.
3. Please email a copy of your son's current immunization record to the admissions office - admissions@heichalhatorah.org.
4. Please send in 7th and 8th grade transcripts and any standardized testing results from 6th grade and on to the admissions office - admissions@heichalhatorah.

Primary Contact's Email Address
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Student Information
First Name:
Your answer
Last Name:
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Street Address
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City, State, Zip Code
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School Currently Attending:
Your answer
Current Rebbe:
Your answer
Current Rebbe Cell Phone Number:
Your answer
Camps Attended:
Your answer
Shul Currently Attending and Name of Local Rav:
Your answer
Rav's Cell Phone Number:
Your answer
Other Rabbinic References
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Other Schools Attended During 4-8 Grade
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Mother Information
Title:
Your answer
First Name:
Your answer
Last Name:
Your answer
Maiden Name:
Your answer
Street Address
If same as above you may leave blank
Your answer
City, State, Zip Code
If same as above you may leave blank
Your answer
Home Phone Number:
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Work Phone Number:
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Cell Phone Number:
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Email Address:
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Employer:
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Father Information
Title:
Your answer
First Name:
Your answer
Last Name:
Your answer
Street Address
If same as above you may leave blank
Your answer
City, State, Zip Code
If same as above you may leave blank
Your answer
Home Phone Number:
Your answer
Work Phone Number:
Your answer
Cell Phone Number:
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Email Address:
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Employer:
Your answer
Sibling Information
Names and Ages:
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Schools They Currently Attend:
Your answer
Camps Attended:
Your answer
Grandparents Information
Maternal:
Names of Maternal Grandparents
Your answer
Address:
Your answer
Phone Number:
Your answer
E-mail address:
Your answer
Paternal:
Names of Paternal Grandparents
Your answer
Address:
Your answer
Phone Number:
Your answer
E-mail address:
Your answer
Heichal HaTorah is concerned with the academic and social needs of each Talmid
Does the applicant have any special medical, social, learning or physical needs and/or have they received any accomodations in school in the past?
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Emergency Contact
Name:
Your answer
Cell Phone Number:
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Email Address:
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By submitting this application, I affirm that the facts set forth in it are true and complete and I give Heichal HaTorah permission to request a transcript from my child's current school.
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