BJUSY Scholarship Application

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USY Scholarship

Scholarships are available for USY dues and programming. Scholarships are available on an ongoing, as needed basis. Please apply here. For any questions reach out to our Youth Director Ethan Fine at youth@beth-jacob.org

* Parent First Name

* Parent Last Name

* Parent 1 Email Address

* Parent 1 Phone

Name of Second Parent (if applicable)

Email of Second Parent (If Applicable)

Phone of second parent (If Applicable)

* Primary Household Address

* Primary Household City

* Primary Household State

* Primary Household Zip

Child's Full Name

Child's Current Grade

* Program for which scholarship is being requested:

BJUSY Involvement:

Beth Jacob and other community involvement:

Do you have a second child who will be attending the program?

Please Select OneYesNo

Child #2's Full Name

Child #2 Current Grade

BJUSY Involvement:

Beth Jacob and other community involvement:

Do you have a third child who will be attending the program?

Please Select OneYesNo

Child #3's Full Name

Child #3's Current Grade

Name of Camp Child #3 will attend

Name & Length of Session for Child #3

Cost of Session for Child #3

BJUSY Involvement:

Beth Jacob and other community involvement:

* Are there special circumstances you want us to be aware of that may impact our allocation?

* What amount are you requesting in scholarship?

Mon, December 11 2023 28 Kislev 5784