waitlist – JYN ACADEMY

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STUDENT'S INFORMATION

Name*

First Last

Street Adress

City

Postal Code

Student E-mail (Please DO NOT enter a parent email in this field.)*

Student Cell Phone

Student Home Phone

Birth Date*

Gender*

Male

Female

Do you have Hebrew School Education or Synagogue affiliation?

Yes

PARENT INFORMATION

Father's Name*

First Last

Father Cell*

Father Work*

Post Title

Father's E-mail*

Father's Occupation

Mother's Name*

First Last

Mother's Cell*

Mother's Work*

Mother's E-mail*

Mother's Occupation

SCHOOL INFORMATION

Grade Entering*

School Attending*

9 Digit OEN Number (Ontario Education Number)

COURSE SELECTION

Classes that are full will be removed from selection. If you don’t see a course and time that
fits your needs please contact us and we will do our best to accommodate you. Upon interest and demand we will consider opening
new locations and class times.

Please Choose Courses

Grade 8 - Tuesdays 6:00-8:00PM (HRE13 - Torah Studies) $700

Grade 9 - Mondays 3:45-5:45 (HRE23 - Torah Studies) $700

Grade 10 - Tuesdays 3:45-5:45 (HZB3M - Philosophy) $700

Grade 11 - Wednesdays 3:45-5:45 (IDC4U - Empowerment & Identity) $700

Grade 12 - Thursdays 3:00-5:00 (HZT4U - Philosophy) $700

For classes with a waitlist, you may go ahead and register. This will place you first in line if spots
open up (people do cancel if they have a conflict). Also, with enough waitlist registrations, we will consider opening an
additional class for that Grade. You will not be charged unless we can accept you and the class time works for you.

By initialing this form you agree to the terms and conditions of JYN Academy. JYN Academy will
issue an Ontario Ministry approved credit to students who are accepted into the program and
fully comply with the program/course requirements and guidelines.

Initial*

Todays Date

How did you hear about JYN Academy?

Name

This field is for validation purposes and should be left unchanged.

STUDENT'S INFORMATION

PARENT INFORMATION

SCHOOL INFORMATION

COURSE SELECTION

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