1) Legal First, Middle & Last Name *
2) שם בעברית: פלוני בן פלוני [הכהן / הלוי] למשפחת פלוני *
3) Date of Birth *
4) Place of Birth *
5) Mailing Address *
6) Email *
7) Home/Primary Phone Number *
10) Work Phone Number
11) Wife's Name (Write N/A if not applicable) *
12) What is your interest in joining the RCA? *
14) Please indicated whether you have a familial relationship to the Rabbis, staff, or leadership at the Yeshiva(ot) listed; if so, please describe the nature of that relationship. *
17) For each area selected above, please indicate the name of the Rabbi(s) or Yeshiva(ot) that tested you. *
18) For each Rabbi and Yeshiva listed, please indicate whether you have a familial relationship to him, or its staff or leadership; if so, please describe the nature of that relationship. *
20a) If You Selected "Other" Above, Please Explain Here (otherwise, write N/A)
22b) If you Selected "Other" Above, Please Explain Here
24) Name, City, State & Country of Post High School Yeshiva #1 *
24a) Dates Attended (Years) *
24b) Tractates and/or Halachot Studied *
25) Name, City, State & Country of Post High School Yeshiva #2 *
25a) Dates Attended (Years)
25b) Tractates and/or Halchot Studied
26) Name, City, State & Country of Post High School Yeshiva #3 *
26a) Dates Attended (Years)
26b) Tractates and/or Halachot Studied
27) Name, City, State & Country of Post High School Yeshiva #4 *
27a) Dates Attended (Years)
27b) Tractates and/or Halachot Studied
28) Other Information about your Yeshiva/Torah Education (including information about ALL OTHER Yeshivos you attended, but not listed above)
32) Name, Address, City, State/Province, Postal Code, Country, Website (if applicable) of Your Most Recent, Relevent Past Employers *
33) Name, Address, City, State/Province, Postal Code, Country, Website (if applicable) of ALL PRESENT EMPLOYERS *
If you selected "Other" above, please explain here
40) Date *
a) First Name, Last Name, City of Residence & Institutional Affiliation of Reference #1 *
b) First Name, Last Name, City of Residence & Institutional Affiliation of Reference #2 *
c) First Name, Last Name, City of Residence, and Institutional Affiliation of the Rabbinic Faculty member of the Yeshiva you learned איסור והיתר who has personal, first-hand knowledge of your character and learning ability *
42) If you are not an active congregational Rabbi, please list the name(s) and Rabbis(s) of the shul(s) where your regularly daven.
43) Please list URLs of personal and professional social media websites maintained by you, or featuring or describing your work. (if applicable)
44) Please list any published books or articles (if applicable)