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Post High School and Beis Medrash Application

Note: If you are over age 23, please fill out the Professionals Program & Kollel application here.

Instructions: Before starting the application, please ensure you have the following ready:

Passport information
Contact information for your Iyun and Bekius Rebbe
Two references who can speak to your current learning ability, general personality, and academic performance
A recent photo of yourself

Please answer all questions. Inapplicable items should be marked N/A. If the student does not have his own email address, please that field blank and we will use the parents email address to contact you.

Step 1 of 7

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URL
This field is for validation purposes and should be left unchanged.
Personal Information
Name*
First Last
Preferred Name
First Last
Hebrew Name (including your surname) - in Hebrew
Email*
Home Phone*
Cell Phone
Place of Birth
Birthdate*
MM slash DD slash YYYY
Full legal name on passport
First Last
Passport Number
Passport Expiration Date
MM slash DD slash YYYY
Do you have an Israeli citizenship*
Do you have an Israeli passport
Country Issuing Passport
Teudat Zehut
(If Israeli Citizen)
Are either of your parents Israeli?*
Mailing Address Type
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Shul
Shul Rabbi
Proposed start and end dates of study
How did you hear about us?
What interests you in Bircas?
What are your interests/ extracurricular activities?
What did you do the past two summers?
What are your plans for this coming summer?

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Education
Current School
Iyun Rebbe
Iyun Rebbe's phone number
Bekius Rebbe
Bekius Rebbe's phone number
Please select your level of learning
How long have you been learning & where
Do you have any learning disabilities?
Do you/have you had medical conditions? If yes, please describe briefly.
Have you taken any medication for more than 2 months at any point during the past 3 years? If yes, please explain.
Have you ever had an assessment? (e.g. Cognitive and Academic Assessments, Social-Emotional Assessments, Special Education and Disability Assessments, College and Career Readiness Assessments)*
Please explain what assessment was taken and why.

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Phones
Do you own a smartphone?*
- Yes
- No
Do you have a filter installed?*
- Yes
- No
Which filter(s)?*
List the names of the people who have the password to your filter, and who manage your filter? (e.g. yourself, you parents, your Rebbe)*

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Parents Information
Father
Father's Last Name
Father's First Name
Father's Title
Fathers Date of Birth
MM slash DD slash YYYY
Fathers Home Address
Fathers Occupation
Fathers Business Phone
Fathers Cell Phone
Fathers Email

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Mother
Mother’s Last Name
Mother’s First Name
Mother’s Maiden Name
Mothers Date of Birth
MM slash DD slash YYYY
Mothers Home Address
Mothers Occupation
Mothers Business Phone
Mothers Cell Phone
Mothers Email
Was your biological mother born Jewish?*
- Yes
- No
Was your biological maternal grandmother born Jewish?*
- Yes
- No
Did you, your mother, or your maternal grandmother convert to Judaism?*
- Yes
- No
Please check who converted
- You
- Your mother
- Your maternal grandmother
Please attach a copy of the conversion documents to your application*
Drop files here or

Max. file size: 512 MB.

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Tuition Contact Person
Please provide contact information of the contact person for tuition arrangements.
Name*
Relationship to you*
Phone
Email*
References
Reference 1
Name*
(your rav if possible)
Occupation*
Relationship to you*
Phone*
Email*
Reference 2
Name*
Occupation*
Relationship to you*
Phone*
Email*
Emergency Contact
Please provide contact information of someone that we can reach out to in in case of an emergency.
Emergency Contact Name
Relationship to you
Home Phone
Cell Phone

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Please have a copy of your latest High School transcript sent to us by the school directly.
Upload Transcript
Accepted file types: doc, docx, pdf, txt, rtf, Max. file size: 512 MB.
Please upload a clear picture of yourself (a headshot).
Photo upload*
Accepted file types: jpg, jpeg, gif, png, Max. file size: 512 MB.
*
- "I have read and understand the fee schedule."
CAPTCHA

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Tuition Policy:

Tuition for the full academic year is 96,000nis (this includes a 8,000nis non-refundable registration fee). Please read the Tuition Policy page for the exact timing of payments, scholarship info and other details. We have also compiled information on External Scholarships.

In This Section:

Online Application
- Post High School and Beis Medrash Application
- Professionals Program Application
Tuition Policy
Scholarships
Contact Me – Post High School Beis Midrash
Contact Me – Professionals Beis Midrash
Medical Procedures & Insurance
Old City Information Page
Regional Scholarships
Family Visits & Housing
New Student Info Form

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Phone: +972-2-627-1647 | e-mail: inquiries@bircas.org

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