Office of the National Registrar
PRINT YOUR NAME EXACTLY AS YOU WISH IT TO APPEAR ON YOUR DIPLOMA/SMICHA.
*If your name or address is different in our system (SIS), it is necessary to submit a change of Name/Address form along with the appropriate documents. This application should be submitted to the National Registrar.
First Middle Name or Initial Last
Address
City
Email
State Zip
Home Telephone
( )
Cellular Telephone
( )
Cincinnati
□Doctor of Philosophy
Los Angeles
□DeLeT, Certificate in Day School
□Hebraic and Cognate Studies, M Phil
□ Hebrew Letters, MAHL
Teaching
□Rabbinical Ordination
□ Master of Arts, MA
□ Doctor of Hebrew Letters
National
□ Executive MARE
□ Cert in Jewish Education
□Doctor of Hebrew Letters
□Doctor of Hebrew Studies
□Hebrew Letters, MAHL
□Jewish Education, MA
□Jewish Nonprofit Management, Cert
□Jewish Nonprofit Management, MA
□Judaic Studies, MA
□Rabbinical Ordination
Student’s Gender Identification:
□ Male □ Female
New York
□Cantorial Ordination
□Doctor of Ministry
□Hebrew Literature, MAHL
□ Rabbinical Ordination
□Religious Education, MARE
□Sacred Music, MSM
□ Cantorial Certificate
Returning after Graduation/Ordination to continue a program of study at HUC-JIR?
□ Yes □ No
If Yes, will you be continuing in the same program of study or have you been formally admitted into a new program?
□ I will be in the same program □ I have been formally admitted into a new program at HUC-JIR.
Program continuing: _____________________________ Program admitted to: _______________________________________
Student’s Full Hebrew Name (e.g., Ploni(t) ben/bat Ploni v'Plonit) *
*If a parent is a Rabbi or a Cantor, please include the honorific "Harav" or HeChazan" before that name (e.g., Ploni(t) ben/bat HeCHazan Ploni v'Plonit)
First Last
Address
State Zip City
Student Signature Date