Sinai Retreats

STUDENT | SCHOLARSHIP | STAFF | ALUMNI WEEKENDS | INTERNSHIP

For cost and payment schedule please see our FAQ page. A limited number of scholarships are available. Please contact Rabbi Teitelbaum for more information.

You can either fill out the form below and send it online or click here to download the application in pdf format or Microsoft Word format . It can be faxed back to us at (301) 681 6580.

(if you do not have adobe acrobat click here to get it)

Introductory Information:
Applicant's Name
Hebrew Name
Legal Address
Which session(s) are you applying for ?

Contact Information:
Mailing Address (if different)
Telephone (work)
Telephone (home)
Telephone (cell)
E-mail
Emergency number

Background Information:
Date of Birth
Place of Birth
Citizenship
Were you ever in Israel?		Dates
Reason for visit
Was your mother born Jewish?
Was your father born Jewish ?
Parent's marital status:

Father’s Name

Mother’s Name

Father’s Address
Mother’s Address
Father’s Occupation
Employer’s Name

Mother’s Occupation
Employer’s Name

Other Children in Family:
Number of brothers
Number of sisters

Education Data

List chronologically all the schools you have attended.
(Include name of school, location, dates of attendance, graduation date and any degrees awarded)
Colleges or Universities:
Jewish Schools (if not included above):
Present occupation, if not attending college
Please detail a brief career bio :

Jewish Education:
Hebrew - Rate your proficiency
Speak
Write
Read
Understand

Detail areas of subject matter studied in following
Bible
Hebrew Literature
Jewish History
Talmud
Other

Additional Information
Languages spoken at home
Activities and organizations in which you have participated
Do you need financial assistance in meeting the tuition requirement of $350 [Before May 15th, the tuition will be $300. After that time it will be $350].
Are there any special characteristics of your Medical_History (including medicines, physical limitations or food requirements)?

List two persons who can serve as a reference for you :
Name
Relationship
Phone/Address

Name
Relationship
Phone/Address

How did you hear about Sinai Retreats?

Please describe what you hope to gain from Sinai Retreats.

Introductory Information:

Contact Information:

Background Information: