Scholarship - JewishTroy.com

LONG LAKE PLAZA SCHOLARSHIP FUND APPLICATION

The Long Lake Plaza Fund was built with the intentions that no child should be turned away from a Jewish Education due to lack of funds. For those families that need the financial aid, we are currently offering a scholarship for the upcoming 2024-2025 Hebrew School year. Fill out this form to apply.
- Terms and Conditions of Scholarship
  
  By applying for this Scholarship I agree to the following; The scholarship will pay for each Sunday that my child attends Hebrew School. I will only be billed for any remaining balance. I authorize the Chabad Jewish Center of Troy to charge my credit card $32 per child for any Sunday missed for whatever reason. It’s my responsibility to make sure that Chabad Jewish Center of Troy has a working credit card on file. If your child/ren attend Hebrew School every Sunday that there is Hebrew School, tuition will be fully covered.
  
  Please note: There is a $100 Registration fee per child is not included in the scholarship.
Parents
Parent 1
Full Name*
E-mail*
Phone Number*

Area Code Phone Number
Employer*
Job Title*
City of Residence*
Marital Status*
Parent 2
Full Name
E-mail
Phone Number

Area Code Phone Number
Employer
Job Title
City of Residence
Marital Status
Children
Number of children being registered
Name of Child Applying for Scholarship*
First Name, Last Name
Date of Birth*

Month Day Year
Child 2 Full Name
First Name, Last Name
Date of Birth

Month Day Year
Child 3 Full Name
First Name, Last Name
Date of Birth

Month Day Year
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.*
Tuition Fees Information:
Amount of Full Tuition
What can you pay towards tuition?*
How much can you receive from other sources (friends or family)?
Please explain source:
Funding from any other agencies or grants:
Please explain source:
Total Amount Requested*
Signature
Full Name*
First Name Last Name
Date*

Month Day Year
Email (for email confirmation and receipt)*
Should be Empty:

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LONG LAKE PLAZA SCHOLARSHIP FUND APPLICATION

Parents

Children

Signature