Scholarship Application - JewishKirkland.com

Scholarship Request Form
The Chabad of Kirkland CGI Camp Scholarship Fund offers financial aid based on economic need. We offer partial scholarships and payment plans. Due to great demand and limited resources, it is important that you provide us with your complete financial picture for full consideration. Scholarships are awarded on a sliding scale and a first come first served basis.
We try to accommodate everyone in our summer camp, because we believe that a Jewish camping experience is an important part of forging a strong Jewish identity. Therefore, we will try to work with everyone who requires assistance, to help come up with an amount that they are are able to pay for the camp experience.
We will work with you personally and a mutually agreed upon fee will be arranged. This will occur in a strictly confidential manner, and we will make every effort to accommodate your request. Please be sure to fill in the entire form.
Your Information
Parent 1
Full Name*
First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*
Parent 2
Full Name*
First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*
Campers information
Camper 1
Full Name*
First Name Last Name
Age *
Weeks *
Camper 2
Optional
Full Name
First Name Last Name
Age
Weeks
Camper 3
Optional
Full Name
First Name Last Name
Age
Weeks
Financial Information
Total List Price* Please find pricing on the Rates page
Amount you can Afford*
Summer Camp Attended Last Year
Paid Tuition Amount
Annual Household Income*
Monthly Housing Expenses* Rent / Mortgage, Utilities
Marital Status*
Filing Tax-Return As:*
Please explain special Financial Circumstances to Consider*
All requests for assistance must be received by March 15th.
Please note, you must have turned in a completed registration form and deposit before you can be considered for a scholarship.
When submitting a camp scholarship request form, please consider the cost of these programs.
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Scholarship Request Form

Your Information

Parent 1

Parent 2

Campers information

Camper 1

Camper 2

Camper 3

Financial Information