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Application Form
medical form
About Us
Our Staff
FAQ
The Dorm
Timetable
What's On
MerkosConnect
Programs
Our Courses
>
Current Courses
Seminary Experience
Themed Programs
>
Past Programs
Shanna Beis Program
Mothers Enrichment Program
Rosh Chodesh Women’s Circle
Contact
Apply
Application Form
medical form
MerkosWomen Application Form
Thanks for your expression in participating in a Merkos Course please fill in the details below so that we can process your enrollment
Personal Information
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
D.O.B
*
Country of Birth
*
Two referees required, one should be a Rabbi
Name of Reference 1
*
Please supply the name and number of two references
Contact Details (email or phone) R1
*
Position R1
*
Contact Details (email or phone) R2
*
Position R2
*
How long have they known you R1
*
Less than 1 month
1-6 months
1-3 years
Over 3 years
Never
Name of Refrence 2
*
References
How long have they known you? R2
*
Less than 1 month
1-6 months
1-3 years
Over 3 years
Never
Courses
Which course would you like to take
*
Summer Learning Vacation
Full Seminary Experience
Tanya - A Tale of Two Souls
Halacha - Jewish law
The Jewish Woman in a Contemporary World
Pirkei Avos - Living an Ethical Life
Rabbi I Have a Question
Creating a Dynamic Relationship
The Jewish Home - Bayis Yehudi
A Mystical Journey Through the Weekly Portion
The Origins of the Chassidic Movement
Gemara
Mothers Enrichment Course
Other
In a few sentences, please tell us what you would like to gain from attending MerkosWomen in Melbourne
*
Do you require accommodation in our dormitory
*
Yes
No
Maybe
How did you hear about the MerkosWomen Program?
*
Internet
Word of Mouth
Magazine/Paper
Rabbi
Other
Submit
