Atidim Israel '23 Application for Financial Aid

Application for Financial Aid
The total cost of the trip per participant is $6,500. We will be offering need-based financial aid. Proof of income is required.
Personal Information

Please fill out this section completely.
Participant Name*

First NameLast Name
Participant Current School*
Participant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone*

Area CodePhone Number
General Financial Information

Fill out the corresponding sections that best describes your situation.
What is your total YEARLY household income?*
How many dependents live in your household? *
Other assistance you receive (please check all that apply)*

Food StampsMedicaidMedicareNone
If you also selected "other" please include what assistance program
What is the total of support/other income you receive per month?*
Do you have a job?*

YesNo
If yes,
How much money can you contribute to the trip?*
Other Circumstances

In the Space below, please describe any financial barriers (e.g. anticipated decreases or increases in income in the coming year; college/private school/preschool/ tuition you pay; monthly student loan payments, etc.) to guide us as we make financial aid decisions.
Reason or Circumstance:*
Please upload your most recent income tax form *

Browse Files

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Signature
I hereby state that all information provided on this form is true and accurate.
Signature*

Clear
Date*

MONTHDAYYEAR
All financial scholarships rewarded will be communicated via email.
Should be Empty:

Application for Financial Aid

Personal Information

General Financial Information

Other Circumstances

Signature