Dear Parents, We are grateful that you are considering Chaya Mushka Seminary as an option for your daughters’ education for the upcoming school year. At Chaya Mushka Seminary, we believe that it is important that all incoming students and their families understand what our goals and standards are prior to registration. As a seminary, our program focuses on in depth learning of Torah and Chassidus along with other important classes and extracurricular activities necessary to instill our students with the values necessary to live in the contemporary world as a proud Chassidishe woman. A warm atmosphere is created based on common respect for Torah and Chassidus and as such it is obvious that all of those in attendance will commit to respecting Halacha and the learning environment. We look forward to your registration, -REGISTRATION DEADLINE: JANUARY 12, 2022 - YUD SHVAT, 5782- Family Information Student Information Student Name* First Name Last Name Student Cell* Area Code Phone Number Student E-mail* What grade are you applying for?* Sem Aleph Sem Beis Secular Birth Date 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Hebrew Birth Date Languages English French Hebrew Spanish Russian Yiddish Portuguese How well do you know English? Understand Understand & Speak Understand, Speak, Read & Write How well do you know Hebrew? Understand Understand & Speak Understand, Speak, Read & Write How well do you know Russian? Understand Understand & Speak Understand, Speak, Read & Write How well do you know Portuguese? Understand Understand & Speak Understand, Speak, Read & Write How well do you know French? Understand Understand & Speak Understand, Speak, Read & Write How well do you know Spanish? Understand Understand & Speak Understand, Speak, Read & Write How well do you know Yiddish? Understand Understand & Speak Understand, Speak, Read & Write Parent's Information Parents Marital Status:* Married Divorced Widowed Father's Information Father Name:* Title First Name Last Name Father Cell Phone:* Area Code Phone Number Father's E-mail:* Father Occupation:* Father Work Place:* Father Work Phone:* Area Code Phone Number Mother's Information Mother Name:* First Name Last Name Mother Maiden Name:* Mother's Cell:* Area Code Phone Number Mother's E-mail:* Mother Occupation:* Mother Workplace:* Mother Work Phone:* Area Code Phone Number Primary Contact:* Father Mother Home Address* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Emergency Contact Emergency Contact Full Name* First Name Last Name Emergency Contact Phone Number* Area Code Phone Number Emergency Contact Relationship to Student* Contact in Montreal Montreal Contact Full Name First Name Last Name Montreal Contact Phone Number Area Code Phone Number Montreal Contact Relationship to Student Education School Name:* School Address:* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country School Phone Number:* Area Code Phone Number Principal Name:* First Name Last Name Principal Phone:* Area Code Phone Number Have you spent your secondary education years (high school) in more than one school?* No Yes List the other secondary school for each year: Recommendations References required: • Your Machaneches who is involved in your education that has been in contact with you recently. Please send your Machaneches this link: www.ChayaMushkaSeminary.com/Machaneches • Two references from people who know you well from your extra curricular activities. Please send the references this link: www.ChayaMushkaSeminary.com/Reference Please list below the references who are submitting letters of recommendation: #1 Full Name* First Name Last Name #1 Phone Number* Area Code Phone Number #1 Position* #2 Full Name* First Name Last Name #2 Phone Number* Area Code Phone Number #2 Position* Interview For Montreal Students, interviews will take place in town. All other the interviews will be arranged once the application is processed. Please choose which day and what time you will be available. Interview Day* Monday Tuesday Wednesday Thursday Interview Time* Morning Afternoon Evening Student This section should be filled out by the student. Extra Curricular Activities Camp Experience I spent the first month of this past summer in: Camp Name:* City:* Position:* Director Name:* First Name Last Name Director Phone:* Area Code Phone Number Head Counselor Name:* First Name Last Name Head Counselor Phone:* Area Code Phone Number I spent the second month of this past summer in: Same place Yes No Camp Name:* City:* Position:* Director Name:* First Name Last Name Director Phone:* Area Code Phone Number Head Counselor Name:* First Name Last Name Head Counselor Phone:* Area Code Phone Number Activities Please fill in the following chart regarding extra curricular activities you have been involved in, such as: Children programs, volunteer work, community projects etc. #1 Type of Activity:* #1 Location:* #1 Position:* #1 Reference Name:* First Name Last Name #1 Reference Number:* Area Code Phone Number #2 Type of Activity:* #2 Location:* #2 Position:* #2 Reference Name:* First Name Last Name #2 Reference Phone:* Area Code Phone Number Questionnaire Please explain why you would like to spend the next year at Chaya Mushka Seminary?* Describe the friends/people you feel close with:* What, in your opinion, is the definition of a chassidishe girl in todays day and age?* Give examples of standards Please describe some of your interests, talents, hobbies or pastimes:* What type of extra curricular programs do you enjoy?* Which programs have you organized or led in your school or community?* Rules & Guidelines Curriculum Our program includes: Nigle: Chumash, Nach, selected topics from the Talmud, Halachah with emphasis on areas of halachic concern for women . Chassidus: including Tanya, Sichos, selected Mamorim, Hashkafa (i.e. Da Ma Lehashiv & 13 Princples) And Inyonei Geula and Moshiach. Early Childhood Education Methodology, and Special Ed. We also offer a variety of other classes such as Finance, Computers and Communication. Schedule Classes are from 8:40 a.m. to 4:00 p.m. as well as various evening classes and programs Shabbos Girls spend Shabbosim in the dorm and are hosted by families in the community. We also have Shabbatons which are hosted in town and sometimes out of town. i.e. Shluchim or Trips. General guidelines Following you will find some of the main rules and guidelines of our seminary. These guidelines stem from our seminaries Hashkafa and standards and will be strictly enforced Internet cafes are not allowed under any circumstances the seminary will provide students with computer and Internet access. Curfew is at 10:30PM sharp and strictly enforced, students must be in a dorm by that time. All students devices i.e. laptops, ipods, ipads and cellphones will be checked at the start of the year and periodically. All seminary rules apply during vacation time as well. Tznius Please note: Tznius guidelines apply at all times throughout the year, including "off" shabbosim and vacations. Students must be completely Tznius at all times in the dorms. Tznius guidelines: Your wardrobe should not include any clothes that are tightly fitting or made of clinging or transparent material. Blouses and tops should not have designs or lettering that reflects pop culture. Jean material is not acceptable. Your blouses should be amply sleeved so as to cover your elbows at all times. The neckline should be closed from all sides. button-down shirts should enable proper coverage. Your skirt should cover your knees, standing and sitting. Slits on any side of the dress or skirt, are not allowed. Your legs must covered at all times. Fish net and loud coloured tights or stockings are unacceptable. You must be completely tzniusdig in your apartment at all times. The Seminary Hanhalah, teachers, and staff are always here for you, and happy to talk about any concerns or difficulties you may encounter with these rules. We want your year to be one in which you are able to grow and advance, and this can only happen in an atmosphere of mutual caring, trust, respect, and a personal sense of responsibility. Please do not hesitate to approach us if needed, to discuss your options and possible alternatives, if you feel these guidelines present a challenge. * I have read the Contract, and accept all rules and guidelines therein. * I intend to attend every class. (Including NDF courses for those registered.) I understand that my presence at all extra-curricular functions, including farbrengens, workshops, outings, trips, games, in-shabbos and shabbatons, will help create a vibrant and inspiring environment for every student, including myself. I intend to participate in this spirit. * I understand that my success in Seminary is dependent on my full adherence to the rules and guidelines outlined in this contract, in and out of seminary. I realize that breaching BCMS rules will carry serious consequences, and may result in dismissal from Seminary. Parents Signature:* Students Signature:* Please upload all applicable documents Medical examination form (download and complete by physician and parents). Can be emailed separately if appointment is after deadline. Click Here to download Medical Form 9-12th Grade High school transcripts 10-11th Grade Report Cards 2 recent color passport size photos (please write your name and school clearly) Click "Browse Files" to upload all applicable Documents If you are receiving a error please allow cookies Application Fee Please submit $75 USD for registration fee: Application Fee Total $0.00 Payment* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 Expiration Year Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Credit Card CVV# Please check all the information you entered to validate accuracy. 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