2023 Financial Assistance Application

DEADLINE: NOVEMBER 18TH

Submit this form, and either scan and upload (mol@a jewishbroward.org), or mail (5890 S Pine Island Road, Davie, Fl 33328) A COMPLETE, SIGNED copy of your most current income tax return and a letter explaining the need for financial assistance or to explain anything you feel the committee should know which is not evident from your tax return. All information will be rendered anonymous when reviewed.

Do not delay in submitting this application.

For questions or additional information, contact Rochelle Baltuch, Director, March of the Living 954 660 2077 or rbaltuch@jewishbroward.org

Participant's Name*

Address

City, State, Zip

Parents' Marital Status

Parent 1 - Full Name*

Parent 2 - Full Name

Parent 1 - Email*

Parent 2 - Email

Parent 1 - Occupation*

Parent 2 - Occupation

Parent 1 - Annual Income before taxes from salary/business*

Parent 2 - Annual Income before taxes from salary/business

Total annual income from other sources - list source and amount (ie stocks, bonds, savings, rental, social security, other family members, etc*

List your expenses- name and amount (ie medical, loan/mortgage, private school/college tuition, outstanding debts, etc*

Upload your most recent COMPLETE AND SIGNED tax return*

Upload a letter explaining your financial situation (optional)

The cost of the 2023 March of the Living is $6595 subject to up to a 5% increase, based on final agreements and arrangements with the International March of the Living. This does not include the cost of trip cancellation/interruption/medical insurance which you will be required to obtain (at a later date).

Indicate below how you plan to cover these costs - you may use an actual number (ie $500), even if it is zero or a % of the balance (ie 25%) in each space

How much from parents*

How much from participant's employment*

How much from savings*

How much from a loan*

How much from other family members*

How much synagogue subsidy*

Other - source and amount*

Do you belong to a synagogue*

YesNo

If so, which one

Minimum financial assistance that will enable applicant to attend the program. We are all aware of the rising costs of all goods and materials, gas, food, etc. The Jewish Federation of Broward County endeavors to make the March of the Living affordable to all. In addition to financial assistance, we will design a payment plan for each family*

By submitting this form you acknowledge it is truthful and understand the forms will be rendered anonymous and shared with the financial assistance committee and any other individual(s) necessary to make the determination of financial assistance. Use your mouse to sign below.

Remember to upload a COMPLETE, SIGNED copy of your tax return and a letter explaining your need

If you have any questions, please contact Rochelle Baltuch, Director, March of the Living at 954 660 2077 or mol@jewishbroward.org

Parent Signature*