Scholarship Form - Chabad of the Mountains

Please fill out as much information as possible.
No Jewish child will be turned away due to lack of funds. Let's work together to make this summer an incredible experience!
Parent 1
Full Name*
First Name Last Name
E-mail*
I would like to receive news and updates by email

Year-round Address*

Summer Address*

Year-round Address*

Summer Address*

Phone Number*
Job title*
Employer name *
Number of children applying for scholarship*
Name and number of Rabbi for reference*
Child 1
Full Name*
First Name Last Name
Birth Date*

Month Day Year
Number of weeks attending camp*
Child 2
Full Name*
First Name Last Name
Birth Date*

Month Day Year
Number of weeks attending camp*
Child 3
Full Name*
First Name Last Name
Birth Date*

Month Day Year
Number of weeks attending camp*
Financial
Please answer the following questions to the best of your ability
Number of children in the family*
Number of adults in the family*
Expected gross income 2026*
Statement of need
Describe any circumstances that support your request for financial aid. The more details you provide, the better we can understand your situation
Is there something you or a family member can offer to enhance our camp? A talent to share? Some time to volunteer?
Tuition Information
Full tuition amount
How much can you pay towards camp tuition?*
How much will you receive from other sources (friends or family)?*
Funding from any other agencies or grants:*
Please add any other details you find necessary to share:
Total amount requested:*
I confirm that all the information contained above is accurate to the best of my knowledge.
Signature
Full Name*
First Name Last Name
E-mail*
*

I have submitted a camp application form
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Please fill out as much information as possible.