Application | Binyan Chaim

Start your marriage with support and guidance—because every Kallah deserves the best beginning.

Kallah Application

"*" indicates required fields

Who is filling out the form?*

Kallah

Someone else

Please share your relationship with the Kallah.*

Email Address*

Phone Number*

Kallah's First Name*

Kallah's Last Name*

Kallah's Mother's Name*

Kallah's Father's Name*

Kallah's Home Address*

Chosson's First Name*

Chosson's Last Name*

Date of Wedding*

Date of wedding must be 6 weeks or later

Do you already have a kallah teacher?*

Yes

Other

Please Explain*

Kallah Teacher Name*

Kallah Teacher Number*

Your Occupation*

Please describe your financial circumstances and why you need financial assistance.*

What shul are you affiliated with?*

Who is the Rav of the shul?

Rav’s phone number

Please provide a reference who can vouch for your financial need along with their contact information.

Reference Name*

Reference Number*

How did you hear about Binyan Chaim?*

Your comfort is important to us. We strive to maintain the confidentiality of your sensitive information. Where applicable, we will reach out to your references so we can better assess your request.

Apply For Assistance

Kallah Application

Start your marriage with support and guidance—because every Kallah deserves the best beginning.

Kallah Application