daycamp

Day Camp Scholarship Application

Project Ezrah is happy to provide small day camp scholarships to local families.

Please submit a separate form for each child you are seeking a scholarship for.
Applications will be reviewed on a rolling basis between now and April 30th, 2023.

Thank you!

"*" indicates required fields

Do you live in Bergen County?*

Yes

Scholarships are only available for children who reside in Bergen County.

Mother's Name*

First Last

Father's Name

First Last

Child's Name*

First Last

School Child is Currently Attending*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mother's Cell Phone Number*

Father's Cell Phone Number*

Mother's Email Address*

Father's Email Address*

Total Number of Household Members Living at Home*

What Grade Levels are All Children in the Household Who Currently Attend School*

Name of Family Rabbi*

Phone Number or Email of Family Rabbi*

We give permission to Project Ezrah to speak with our Rabbi*

Yes

What Camp will your Child be Attending?*

Will Your Child be Attending One or Two Sessions of Camp?*

1 Session

2 Sessions

Full Price of Camp*

How much can you contribute to day camp for this child?*

Total Amount Currently in Checking and Savings*

Total Household Monthly Salary*

What is your monthly rent/ mortgage payment?*

What is your total annual tuition obligation*

Please give a total for all children

Are you receiving any other forms of assistance (ie Tomchei Shabbos, School Scholarships etc. Note: You are still likely eligible for funds, even if you do receive from other sources) If yes please explain. **

Is there anything else you would like us to know about?*

Day Camp Scholarship Application

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