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Dear Applicant,

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

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

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






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