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: This page uses 128 bit SSL encryption to keep your data secure.