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2023 Congregation Beth Israel Jewish Summer Camp Scholarship Application

Answer all questions completely. All information will be treated with the strictest confidentiality. If you have questions about completing this application, call Kerri Zerlin, Assistant Director of the MBJLC, at 713-771-6221 *312 or email at kzerlin@beth-israel.org. Please submit this application by March 24, 2023.

 
I. Student Information
 

II. Parent/Guardian Information
 
Parent/Guardian 1: 
Parent/Guardian 2: 

III. Family Information
 
Date of divorce or separation:
Custodial parent: 

IV. PARENTS’ FINANCIAL INFORMATION (Please provide ALL information requested)
 
Note: You must be a member in good standing with MBJLC tuition, fees, and fair share dues up to date for the 2021-2022 fiscal year in order to be eligible for a scholarship.

V. COST/FUNDING INFORMATION
COSTS
FUNDING

We have reviewed this application and affirm that the information given is complete and correct.
 
Signature of parent or guardian
Date
Signature of parent or guardian
Date
Fri, February 3 2023 12 Sh'vat 5783