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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
*
Month
Day
Year
Gender
*
Male
Female
Do you have Hebrew School Education or Synagogue affiliation?
Yes
No
PARENT INFORMATION
Parent Marital Status
Parent Marital Status
Single
Married
Divorced
Widowed
Other...
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
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Todays Date
Month
Day
Year
How did you hear about JYN Academy?
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