Overnight Jewish Summer Camp
and Israel Experience
Scholarship Program Application

For more information about the scholarship program,
please visit the relevant part of our website.

All information entered is confidential.

Child needs to be registered at a summer program and the family needs to have applied to at least one other source of scholarship before completing this application.

If you have any questions about or problems with this form, please email [email protected]

Websites for Other Scholarships:

Goldring Jewish Summer Camp Experience

RoseMary and Saul Brooks Fund for Jewish Youth Engagement

JCRS - Jewish Children's Regional Service (priority deadline is February 15)

Camper Information

Youth Name*

Date of Birth*

Grade in the 24-25 School Year*

Jewish Camp or Israel Program Child Will Attend*

Name of Program at Above Camp (Example: Maskilim at Jacobs Camp)*

Beginning Date*

Ending Date*

New Camper or Returning Camper?*

Full cost of Program*

Please indicate the amount your family, perhaps supported by other family members, will contribute towards the Camp Fee:*

Total Amount of Scholarship Family is Requesting for this Child from the North Louisiana Jewish Federation:*

Check here if you need to enter information for a second child

Other Scholarship Information

Other Sources of Scholarship Family Has Applied For:*

Goldring Jewish Summer Camp Experience
for first-time campers
RoseMary and Saul Brooks Fund for Jewish Youth Engagement
not applicable to families in Shreveport-Bossier
JCRS Short Form
JCRS Long Form
Other

Amount(s) Expected from Other Source(s)*

Parent/Guardian Information

Parent or Guardian Name*

Email*

Phone Number*

Address*

Parent Occupation*

Check here to enter information for a second parent or adult

Congregational affiliation (name and city). If unaffiliated, please select "none."*

Additional Information You Would Like to Share:

Acknowledgement and Signature

Please read each statement and check the box to indicate agreement.

I certify that all information in this application is accurate to the best of my knowledge.

I understand that scholarship funds are limited. Past awards do not guarantee future awards. Award values change each year with the change of available dollars for scholarships.

I agree to maintain confidentiality with regard to the application, associated discussion, and award decisions

Parent/Guardian Virtual Signature*

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Overnight Jewish Summer Camp and Israel Experience Scholarship Program Application

Camper Information

Other Scholarship Information

Parent/Guardian Information

Acknowledgement and Signature

Overnight Jewish Summer Camp
and Israel Experience
Scholarship Program Application