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Dear Applicant,

Please fill out the form below to apply for a Camp Scholarship.

You will receive an email confirmation once you have submitted your application.

Do not expect any response before May 6, 2019. We will notify you after that date of the status of your application. Applications will be marked approved/denied/pending funding.

Please note: Filling out an application is not a guarantee.
Parent/Guardian Information
First Name: *
Last Name: *
Address: *
Neighborhood *
City: *
State: *
Zip Code: *
Phone Number: *
Email Address: *
Shul Affiliation: *
Rabbi: *
Rabbi Phone: *
Marital Status: *
Both spouses employed the full summer: *
Children Information
Amount of Children Attending Camp *

Are you receiving a Camp Tuition Break?
Please list all help

Additional Comments or any extenuating circumstances:
I affirm that all funds are needed *
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