Application for Scholarship Funds to Supplement Tuition
The Joel Blue Scholarship Fund was established in loving memory of Joel Blue by his family for the purpose of providing partial scholarships for children whose families demonstrate need to pay tuition. The Blue family hopes to make Gan Ami School Year Classes more accessible to all.
Scholarship applications are due by June 1 prior to the start of school.
To apply for a scholarship, please complete the form below. Please note: Temple Beth Ami membership is not required to receive a scholarship, though we welcome you to consider joining our community. Please contact our Main Office, Debbie Ezrin, Executive Director, at dezrin@bethami.org
Parent 1 Name
*
First Name
Last Name
Parent 1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent 1 Primary Phone Number
*
Please enter a valid phone number.
Parent 1 Email Address
*
example@example.com
Check here if applicable:
I am a single parent
Parent 2 Name
*
First Name
Last Name
Check here if applicable:
Address is the same as Parent 1
Parent 2 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent 2 Primary Phone Number
*
Please enter a valid phone number.
Parent 2 Email Address
*
example@example.com
Gan Ami School Child/Children's Name(s) and Age(s)
*
Other Children in Your Family, Name(s) and Age(s)
Amount of Financial Aid Requested
*
$
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Income
Parent 1 Employer
*
Parent 1 Occupation
*
Parent 1 Total Annual Salary
*
$
Parent 1 Other Income (including dividends, interest)
*
$
Parent 2 Employer
*
Parent 2 Occupation
*
Parent 2 Total Annual Salary
*
$
Parent 2 Other Income (including dividends, interest)
*
$
Total Family Income
$
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Expenses
Includes mortgage, utilities, cars, tuitions, credit card payments, insurance, etc.
Total Family Expenses
$
If parents/guardians live separately or pay separate expenses, please specify each person's expenses:
Parent 1 Expenses
Parent 2 Expenses
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Assets
Total Liquid Assets (include savings, CDs, bonds, etc.)
*
$
Total Fixed Assets (including primary residence, other property, businesses, cars, etc)
*
$
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Need
Please attach a statement explaining your family's need for a scholarship.
*
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Statement of Certification
By signing this form, I/we understand that my/our child(ren) must meet all requirements for attendance in Temple Beth Ami's Program. I/We understand that my/our Temple accounts must be current in order to maintain the Scholarship. The Scholarship is for use during the coming school year only, and further scholarships for successive years will require annual application. I/We certify that the above information is complete and accurate, and I/we will supply documentation of this information as requested by the Committee.
Parent 1 Signature
*
Parent 2 Signature
*
Submit
Should be Empty: