Dashboard - Admin - Pending Tuition Contracts

⬅️Go Back

	Workflow Admin
DEPRECATED Username	alex16
PARENT CRM EID	9650
Account Information
DEPRECATED Bochur's Name
Your Bochur's Name	Shlome Chontow
Bochur is a	New Student
Bochur EID	9250
Your Name	Shimon Chontow
Phone Number	+447975567927
Email Address	Email hidden; Javascript is required.
Health Insurance	IT IS MANDATORY THAT EVERY TALMID HAS HEALTH INSURANCE WHILE IN YESHIVA. You will receive an email with more information about obtaining health insurance, upon submitting this form.

Tuition and Payments	Standard tuition is $2,000.00 per month.
Scholarship Request	I would like to request a reduced tuition
Requested Monthly Tuition	$800.00
Confirmed Monthly Tuition	$800.00
WARNING - Reduced Tuition	I understand and agree to the below You have indicated that you would like to request a reduced tuition. Please note that all tuition reduction requests will be submitted to the Rosh Yeshiva for review and approval. There is no set timeframe for this process and it may impact your son's ability to enter the zman on time.
Payment Options	Check
Name on Account	Alexander Chontow
Account Type	Checking
Account Number	92736522
Routing Number	090129
Tuition Electronic Debit Consent	I have read and confirm understanding of the following: On the 1st of every English calendar month, Yeshivas Mishkan Shmuel will directly debit the above bank account for the agreed-upon amount of my son's monthly tuition.
Third Party Organization
Other Third Party Organization Name
Tuition Credit Card Consent
Expenses Credit Card Consent	I have read and confirm understanding of the following: Yeshivas Mishkan Shmuel will charge the credit card labeled "Expenses" above at various times for the amount of $300 each, for the periodic Shabbatons on which the Yeshiva takes all enrolled students. Additionally, in the case that my son arrives to yeshiva without medical insurance, the credit card labeled "Expenses" above will be charged for the cost of obtaining a medical insurance policy for him.

Important Documents
Upload Picture of Bochur's Passport
Upload Picture of Bochur's Birth Certificate
Bochur's Legal Name	Alexander Chontow
Bochur's Passport Number	140895269
Bochur's Date of Birth	13/10/2004
Bochur's Passport Country	GBR
Bochur's Passport Issued On	30/05/2023
Bochur's Passport Expires On	30/05/2033
Does the Bochur Have a Valid Visa?	No
Upload Picture of Bochur's Valid Visa
Mispar Zehut
Upload Picture of ID with Mispar Zehut
Visa For	Myself
Missing
Visa Information	A Student Visa is typically valid for 2 years. The yeshiva will oversee the Student Visa application process. There is a $200 processing fee.
Father's Name	Simon Chontow
Father's Date of Birth	28/03/1977
Are either of the parents Israeli?	Neither
Mother's Name	Shoshana Chontow
Mother's Date of Birth	03/03/1977
Mother's Maiden Name	Olsberg

Tuition Contract Status	Accepted
Entry Notes