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Scholarship Form

Scholarship Form

Scholarship Form!

Please fill out the form below carefully. When you press submit, this form will be sent to our administration office.
Scholarships will be offered on a first come, first served basis.

Camper/Parent Information
Child 1
  First Name

Hebrew Name

Age Boy Girl

 

Child 2
  First Name
Hebrew Name

 

Age Boy Girl

 

Child 3
  First Name
Hebrew Name

 

Age Boy Girl

 

Address
  Street
City State
Zip
Marital Status
  Head of Family
Married Separated Divorced Widowed
 
Father
  First Name
Last Name
Work Phone
Cell
Father's
Address
 

Same. Street

City State
Zip
Mother
  First Name
Last Name Work Phone Cell
Mother's
Address
 

Same. Street

City State
Zip
 
         
Occupation:
Father
 
Employer # of years
  Gross Annual Salary
(Est.)

Phone

Father
  Street City State
Zip
Mother
  Employer
Number of years

Gross Annual Salary
(Est.)

Phone

Mother
  Street City State
Zip
 

 

Other Income Sources:

Amount:
 
 
General Information:
Home
  Do you own your home? What is your monthly mortgage?
Do you rent your home? What is your monthly rent?
Car
  Auto 1
Year Make
Auto 2
Year Make
 
Other Children
  Child 1: Age:
Name:
Child 2: Age:
Name:
Child 3: Age:
Name:
Child 4: Age
Name:
Other Children
  Do you have any children in out-of-town schools?
Yes No
Are you a one-parent family?
Yes No
Do you have any extraordinary expenses (medical bills, etc.)?
    What is the absolute most you can pay?  
         
Any additional information or comments that you want to add?
         
     
IMPORTANT
I understand that I need to send in a copy of my last Tax Return in order to be considered for a scholarship.

I understand that by enrolling in Camp Gan Israel I am agreeing to abide by all its policies.
   
  Date of Application: Initials: