JSV / APJCC Scholarship Application for Internal Programs

JSV / APJCC Scholarship Application for Internal Programs

JCC Maccabi (Team San Jose), Heder, Club Mitzvah, After-School Enrichment, Preschool Enrichment, PJ Library Family, Beged Kefet, Swim Lessons, Swim Team
- Scholarship applications for these programs are accepted on a rolling basis and due four weeks prior to the start of the program.
- Notifications are on a rolling basis and are typically within 2-4 weeks of appplication submission.
To submit this application, the following documents must be uploaded in the upcoming sections for both the primary and secondary parent / guardian:
- Most recent Federal 1040 Tax Return.
- Most recent pay or pension stub, current 1099s, W-2's and Social Security award letters.
- Program registration form(s) for each program participant.
Please email scholarships@jvalley.org with any questions regarding this form.
Parent / Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Second Parent / Guardian Name (if applicable)

First NameLast Name
Second Parent / Guardian Phone Number
Please enter a valid phone number.
Second Parent / Guardian Email Address
example@example.com
Are you an APJCC Member?*

YesNo
Are you currently unemployed*

YesNo
Is Second Parent / Guardian unemployed (if applicable)?

YesNo
Do you or Second Parent / Guardian work at JSV, APJCC Fitness or APJCC Preschool?*

YesNo
If you answered yes to the above question, please indicate whether you are Full-Time, Major Part-Time, Minor Part-Time, Temporary or Seasonal.
Which program are you requesting a scholarship for?*

JCC Maccabi (Team San Jose)HederClub MitzvahAfter-School EnrichmentPreschool EnrichmentPJ Library Family ProgramsBeged KefetSwim LessonsSwim TeamOther (please state which program in the free text box below)
If Other, please specify program.
What is the total program tuition and fees?*
Please provide a dollar amount ($)
What percentage of the total program tuition and fees are you able to contribute?*
Please provide a percentage (%)
Please upload your most recent Federal 1040 Tax Returns for both the primary and secondary parent / guardian (where applicable). *

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Please upload your most recent pay or pension stub, current 1099s, W-2s, or Social Security award letters for the primary and secondary parent / guardian (where applicable). *

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Please upload your registration application form(s) for each program participant. NOTE: Registration is required before submitting a scholarship application. *

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Please upload the completed Excel file which you would have downloaded from the Scholarship page (link to JSV Scholarship page : https://www.jvalley.org/scholarship/)*

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Please describe your need, circumstances and how this program will benefit you and your family*

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Please list each of your dependents on a separate line along with your relationship to them and their birthdates and which program you need assistance with.*

	Name of Child	Birthdate	Relationship to Child	Name of Program
Child 1
Child 2
Child 3
Child 4

The following questions pertain to regular monthly expenses.

Expenses that are "unusual" for your family, such as medical expenses, support that is given to family members who are not your legal dependents, etc. should be listed under "Other".
Mortgage/Rent*
Please provide a dollar ($) amount
Real Estate Taxes
Please provide a dollar ($) amount
Auto/Other Loans
Please provide a dollar ($) amount
Healthcare Costs
Please provide a dollar ($) amount
Childcare (Non-APJCC Programs)
Please provide a dollar ($) amount
Groceries
Please provide a dollar ($) amount
Utilities
Please provide a dollar ($) amount
Spousal Support
Please provide a dollar ($) amount
Child Support
Please provide a dollar ($) amount
Other School Tuition (Non-APJCC)
Please provide a dollar ($) amount
Other (Please provide a description of each expense)
Please provide explanation with dollar ($) amount
Total Monthly Expenses*
Please provide a dollar ($) amount
PLEASE NOTE: If you change/decrease your enrollment, your award will also change.
By clicking "Submit", you agree to the following:

I, the undersigned, understand that the information I provide must be accurate and verifiable. I agree to provide any additional information that JSV/APJCC reasonably requests, and to allow the JSV/APJCC to make such reasonable inquiries as it deems necessary in this regard, including without limitation, to banking institutions and credit reporting agencies.

I understand that if any of the foregoing information is inaccurate, the JSV/APJCC may take appropriate action at its sole discretion, including without limitation, the withdrawal of any scholarship assistance. In addition, I acknowledge that in the event that my scholarship is withdrawn, I will be expected to pay the balance of the prevailing fee.
Thank you for your submission. We will be in touch once your appplication has been reviewed.

If you have any questions, please contact scholarships@jvalley.org.
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