General Scholarship Application

Scholarship Application 2021

Moshava of Wild Rose
Scholarships are awarded based upon financial need. Our deadline for the first review of applications will be on November 1, 2020. Scholarships are limited and will be awarded on a first come, first served basis. All applications received after November 1st will be considered in our second review of scholarships on January 15, 2021. To ensure review for maximum scholarship opportunities we encourage you to apply for the first round. Anyone applying for a Moshava Scholarship must also apply for a scholarship through their local Federation, and submit an email reflecting the confirmation that your application had been received.
CAMPER INFORMATION:
How many campers do you intend to send to camp?

1 2 3 4
Camper 1 full name: *

First Name Middle Name Last Name
Please Indicate for Camper 1: *

New Moshava Camper Returning Moshava camper
How many years at Moshava: *
If new, please list other Jewish overnight camps camper has attended, and for how long:
Gender: *
Birthdate: *

Month Day Year
Date
Camper's Place of Birth: *
Age: *
Grade to be completed in June 2020: *
Camper 1 attends: *

Public school Private school
Camper 2 full name: *

First Name Middle Name Last Name
Please Indicate for Camper 2: *

New Moshava Camper Returning Moshava camper
How many years at Moshava: *
If new, please list other Jewish overnight camps camper has attended, and for how long:
Gender: *
Birthdate:

Month Day Year
Date
Camper's Place of Birth: *
Age: *
Grade to be completed in June 2020: *
Camper 2 attends: *

Public school Private school
Camper 3 full name: *

First Name Middle Name Last Name
Please Indicate for Camper 3: *

New Moshava Camper Returning Moshava camper
If new, please list other Jewish overnight camps camper has attended, and for how long:
How many years at Moshava: *
Gender: *
Birthdate:

Month Day Year
Date
Camper's Place of Birth: *
Age: *
Grade to be completed in June 2020: *
Camper 3 attends: *

Public school Private school
Camper 4 full name: *

First Name Middle Name Last Name
Please Indicate for Camper 4: *

New Moshava Camper Returning Moshava camper
How many years at Moshava: *
If new, please list other Jewish overnight camps camper has attended, and for how long:
Gender: *
Birthdate:

Month Day Year
Date
Camper's Place of Birth: *
Age: *
Grade to be completed in June 2020: *
Camper 4 attends: *

Public school Private school
Home Address *

Street Address

Apt/Unit #

City State

Zip Code
Phone Number *

Area Code Phone Number
Camp Moshava strongly encourages scholarship applicants to seek additional scholarship funds from a third party, and will take efforts made in this regard into consideration when determining scholarship grants.
*****This Section MUST be Completed*****

Cost/Funding Information
Costs: Camp Tuition *
$

Funding: *

Funding

Parent Contribution

Congregation Contribution

FEDERATION REQUEST

Other Sources

Discounts already received from Camp Moshava

Requesting from Camp Moshava

TOTAL

NOTE: COSTS and FUNDING MUST BALANCE

Scholarship Application 2021