KOSHER - Camp Scholarship Application

APPLICATION NUMBER:

210275

Our scholarship deadline has been reached and applications are now closed for 2021

Family Information

Family Last Name:

Address:

City:

State: New York

Zipcode:

Telephone:

10 digit phone number required

Email:

Valid email address is required

# of Children in Family:

# of Children applying:

Father's Name:

Father's Cell:

10 digit phone number required

Occupation:

Employer's Name:

Employer's Phone:

10 digit phone number required

Annual Salary: $

Mother's Name:

Mother's Cell:

10 digit phone number required

Occupation:

Employer's Name:

Employer's Phone:

10 digit phone number required

Annual Salary: $

Camp Information

Child 1

CHILD FIRST NAME ONLY:

Age:

Month 1

Camp Name:

Amount camp is charging you for month 1: $

Month 2

Camp Name:

Amount camp is charging you for month 2: $

CHOOSE 1 CAMP TO SEND THE TOTAL SCHOLARSHIP AMOUNT AWARDED TO YOUR FAMILY

Notes:

Date: