Confidential Camp Scholarship Application All scholarships are handled in a sensitive manner, with absolute confidentiality. You will be contacted with the committee's decision when it becomes available. You must respond to the Camp Gan Israel office before the included deadline in order to accept the scholarship. If you are not satisfied with the committee's decision, your card will not be charged and all deposits will be returned in full. Deadline to fill out the scholarship form is February 16th. Parents Parent 1 Full Name* E-mail* Phone Number* Area Code Phone Number Employer* Job Title* City of Residence* Marital Status* MarriedSeparatedDivorcedWidowedOther Parent 2 Full Name E-mail Phone Number Area Code Phone Number Employer Job Title City of Residence Marital Status MarriedSeparatedDivorcedWidowedOther Children Name of Child Applying for Scholarship* First Name, Last Name Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year How many weeks will your child be attending camp?* Child 2 Full Name First Name, Last Name Date of Birth 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year How many weeks will your child be attending camp? Child 3 Full Name First Name, Last Name Date of Birth 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year How many weeks will your child be 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 2023* 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 Fees Information: Amount of Full Tuition What can you pay towards camp tuition?* How much can 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* Signature I confirm that all the information contained above is accurate to the best of my knowledge. Full Name* First Name Last Name Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Email (for email confirmation and receipt)* * I have submitted a Camp Registration form. Submit Should be Empty: This page uses TLS encryption to keep your data secure.