HDNA Scholarship Application (Workshop 72)

HDNA Workshop Program Scholarship Application

For questions or concerns, please email Sue Aistrop at finance@habonimdror.org or call the HDNA Central Office at (267) 908-7005, Ext.1 . Please try to submit your scholarship application by April 18th, 2022.
Applicant Full Name *

First Name Middle Name Last Name
Birthdate: *

Month Day Year
Cell Phone Number *

Area Code Phone Number
Preferred Contact Email: *
Where the confirmation will be send to
Parent/Guardian E-mail:
If applicable, which HDNA machaneh do you attend?
Home Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Parent 1 Living *

Yes No
Parent 2 Living *

Yes No
Are your parents divorced? *

Yes No
Are your parents seperated? *

Yes No
I live with... *

Parent #1 Parent #2 Both Parents
Who will be paying for the program?
If more than one person is assisting you to pay for Workshop, please indicate your relation to them and the amount that they will be providing to support your Workshop tuition.
If you have previously been involved with Habonim Dror in the past, please describe your involvement, including the dates you attended machaneh (camp), and your involvement in the past two years in the ken (year-round activities) and at machaneh.
Explain how you plan to bring your experiences from the program back to Habonim Dror North America. Please explain in both the short term and long term. *
We encourage all participants to apply to additional scholarship sources, if possible. What other financial scholarships/grants have you applied for or received? Please include the name of scholarship and amount requested/received: *
You must upload with this application an official copy of your familiy's most recent tax return. *
This is a secure platform and the file will be immediately deleted after review
If your families income has changed in the past year, please explain why and what the significance is here:
Please use this space to explain anything else that might be significant to your financial situation that is not represented in your tax returns:
Are there other special considerations you would like us to be aware of? *
Are you a Canadian resident/citizen? *

Yes No
Habonim Dror North America is offering a needs based sliding scale cost of anywhere between $16,200-$18,200 for Canadian families. Would you like to opt-in to be considered for the sliding scale? *

Yes No
Is there anything we need to know about your financial situation in regards to the sliding scale?
Should be Empty:

HDNA Workshop Program Scholarship Application