CGI Scholarship Form

Before applying for a scholarship, please be aware that the registration process must be completed first. This is done by filling out the Camp Gan Israel registration form for your child/ren and submitting a deposit. Scholarships are granted based on need, availability of funds and on a first come, first served basis. A limited amount is available, so apply early!

Number of children you are applying for:*

Child Full Name*

First Name Last Name

Birth Date*

Month Day Year

Gender*

FemaleMale

Child 2 Full Name

First Name Last Name

Birth Date

Month Day Year

Gender

FemaleMale

Child 3 Full Name

First Name Last Name

Birth Date

Month Day Year

Gender

FemaleMale

Father's Full Name*

First Name Last Name

Phone Number*

E-mail*

Mother's Full Name*

First Name Last Name

Phone Number*

E-mail*

Please choose one*

MarriedDivorcedSeparated

Parent 1 Occupation*

Parent 1 Employer's Name*

Parent 1 Employer's Address*

Parent 1 Annual Gross Salary*

Parent 2 Occupation*

Parent 2 Employer's Name

Parent 2 Employer's Address

Parent 2 Annual Gross Salary

How much are you requesting as a scholarship for CGI?*

How many children are in your family?*

Which schools do your children attend?*

SIGNATURE: I certify that all of the information is true and that all income is reported. I understand that the information is being given to the scholarship committee in order to evaluate the need for a scholarship, and that all information submitted will be kept confidential.

Signature*

*

Month Day Year

Child/ren you are applying for:

Parent's Info

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