Parent Form

Northwest Yeshiva High School

Parent Application 2020-2021
Student's Name *

First Name Last Name
Gender
Birth Date *

Month Day Year Date Picker Icon
Place of Birth
What Grade will the student be entering during the 2020-2021 School Year? *
Student's Email
example@example.com
What Grade will the student be entering during the 2020-2021 School Year? *
Are you interested in speaking with our Learning Support Specialist?

YES NO
1st Parent/Guardian Name *

1st Parent/Guardian Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

1st Parent/ Guardian Email *
example@example.com
1st Parent/Guardian Mobile Phone *

Area Code Phone Number
2nd Parent/Guardian Name

2nd Parent/Guardian Address (if different)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

2nd Parent/Guardian Email
example@example.com
2nd Parent/Guardian Mobile Phone

Area Code Phone Number
Would the parents/guardians prefer separate mailings?

YES NO

Sibling Information:

	Name(s)	Age	Grade	School

Family Members Who Have Attended NYHS:
Jewish Education and Experiences

Please list all Jewish Youth Groups, camps, Hebrew schools, or other programs the student attended or participated in the past three years as well as the Synagogue(s) they have attended in that time.
Name of Program, Group, Camp, or Membership and Dates of Attendance or Membership *
Why would you like your child to attend NYHS? *
What are your expectations for your child's high school experience? *
If there is any additional information that you would like to share with us, please do so here. *
Should be Empty: