Max Weinreich Center for Advanced Jewish
Studies

2004 Uriel Weinreich Program in
Yiddish Language, Literature, & Culture
Application Form
NOTE: An application form for the 2005 Summer Program
will be posted in January 2005.

Please type your entries into the appropriate boxes, print out this form, and mail it to:

Dr. Paul Glasser

Associate Dean, Max Weinreich Center

YIVO Institute for Jewish Research

15 West 16th Street

New York, NY 10011-6301, USA

Note: This form displays and prints best on PCs with Internet Explorer or Netscape. Please print out and fill in by hand if problems are encountered when filling out online.

Include with your application:

• $35US non-refundable application fee, made payable to Columbia University (Funds must be drawn from a U.S. bank. Do not send postal money orders. The applicant's name must appear somewhere on the payment.)
• Detailed outline of education (dates of enrollment, degrees, expected date of degree) and previous study of Yiddish, Hebrew and/or German (program, duration, dates of course[s] and material covered)
• Background in Jewish or Yiddish studies
• Brief biographical description and reason(s) for interest in program (400-word maximum)
• 150-word uncorrected Yiddish writing sample (for applicants to the intermediate or advanced levels)

		Name   (First name, then family name)     Yiddish Name (optional)     Address City State Zip/Postal Code Country Email Address Telephone Fax       Social Security Number       Date of Birth Month Day Year      Male     Female
		Country of Origin:   U.S. Citizen? Yes No   If Not, What Country?               Highest level of education attained:         Person to contact in case of emergency:   Daytime telephone number of person:   Evening telephone number of person:       I am applying for: (Instructors will review placement level at the beginning of the program.)   Elementary   Intermediate I   Intermediate II   Advanced   I am interested in:   Reading Skills Workshop (for elementary students)   Housing at Yidish-Hoyz   Refresher Course   Please send me:   Scholarship Application Form