Grades 1-8 Waitlist Form

Thank you for your interest in Yeshivas Ohr Reuven. This Form is to be filled out for grades where our classes are full.

You may fill out this form to place your son on our waitlist. Please note that this form is NOT a formal application and does not imply kadima or acceptance to Yeshivas Ohr Reuven. Should a slot become available, you will be contacted to fill out a formal application.

Student

Last Name*

First (and Middle)*

Admission for School Year*

Date of Birth*

Current Yeshiva

Yeshiva Talmid Currently Attends*

Parents

Marital Status*

Father

Father's Title*

Father's Name*

Father's Position and Employer*

Father's Cell Number*

Father's Work Number

Father's Email*

Mother

Mother's Title*

Mother's Name*

Mother's Position and Employer*

Mother's Cell number*

Mother's Work Number

Mother's Email*

Mother's Maiden Name*

Contact Information

Home Phone Number

Home Address*

Apt

City*

State

Zip*

Grandparents

If a grandparent remarried, please select “+ Add More”. This will provide us with correct names and mailing information.

Relationship

Does student have grandparents?*

If a grandparent remarried, please select “+ Add More”. This will provide us with correct names and mailing information.

Relationship

Does student have grandparents?*

Add More

Siblings

First Name*

School Attending*

DOB*

Gender*

Add More

Yeshiva Affiliation

Are you already affiliated with Yeshiva?*

Information Release Consent

Did you ever apply to our yeshiva before?

I give permission for Yeshiva Ketana Ohr Reuven to contact my son’s current or previous teacher/school, Rav, etc. Information requested may include: conferencing with school personnel, observation in classroom setting, reports, or other related records.*

I hereby certify that the information given in this application is complete and accurate.

Signature of Parent*

Date*

When you click "SUBMIT" you will get to the payment page.
DO NOT press back as it will take you out of the payment page and you will not be able to come back into the payment page.
Fee must be paid via credit card only, no cash or checks please.

Should you need assistance with submitting this application, please contact Mrs. Weisman. at 845.362.8362, ext. #117.

Code (Not Required)