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STUDENT'S INFORMATION

Name*
Birth Date*
Gender*
Do you have Hebrew School Education or Synagogue affiliation?

PARENT INFORMATION

Father's Name*
Mother's Name*

SCHOOL INFORMATION

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
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.
Todays Date
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© JYN Academy 2016