General Scholarship Application

Scholarship Application 2026

Moshava of Wild Rose
Families will be charged monthly based on the tuition pricing until a FULL SCHOLARSHIP APPLICATION HAS BEEN SUBMITTED.

Scholarships are need based and will be given first come first serve. Review will take place on Nov 1, Jan 15 and March 15. Pease note you will need to submit your most recent tax returns and then email in your 2025 tax returns in 2026 for the scholarship to be upheld. Anyone applying for a Moshava Scholarship must also apply for a scholarship through their local Federation, and submit an email reflecting the confirmation that your application had been received.
CAMPER INFORMATION:
How many campers do you intend to send to camp?

1234
Camper 1 full name:*

First NameMiddle NameLast Name
Please Indicate for Camper 1:*

New Moshava CamperReturning Moshava camper
How many years at Moshava:*
If new, please list other Jewish overnight camps camper has attended, and for how long:
Gender:*
Birthdate:*

MonthDayYear
Date
Camper's Place of Birth:*
Age:*
Grade to be completed in June 2025: *
Camper 1 attends:*

Public schoolPrivate school
Camper 2 full name:*

First NameMiddle NameLast Name
Please Indicate for Camper 2:*

New Moshava CamperReturning Moshava camper
How many years at Moshava:*
If new, please list other Jewish overnight camps camper has attended, and for how long:
Gender:*
Birthdate:

MonthDayYear
Date
Camper's Place of Birth:*
Age:*
Grade to be completed in June 2025: *
Camper 2 attends:*

Public schoolPrivate school
Camper 3 full name:*

First NameMiddle NameLast Name
Please Indicate for Camper 3:*

New Moshava CamperReturning Moshava camper
If new, please list other Jewish overnight camps camper has attended, and for how long:
How many years at Moshava:*
Gender:*
Birthdate:

MonthDayYear
Date
Camper's Place of Birth:*
Age:*
Grade to be completed in June 2025: *
Camper 3 attends:*

Public schoolPrivate school
Camper 4 full name:*

First NameMiddle NameLast Name
Please Indicate for Camper 4:*

New Moshava CamperReturning Moshava camper
How many years at Moshava:*
If new, please list other Jewish overnight camps camper has attended, and for how long:
Gender:*
Birthdate:

MonthDayYear
Date
Camper's Place of Birth:*
Age:*
Grade to be completed in June 2025: *
Camper 4 attends:*

Public schoolPrivate school
Home Address*

Street Address

Apt/Unit #

CityState

Zip Code
Phone Number*

Area CodePhone Number
Camp Moshava strongly encourages scholarship applicants to seek additional scholarship funds from a third party, and will take efforts made in this regard into consideration when determining scholarship grants.
*****This Section MUST be Completed*****

Cost/Funding Information
Which sessions are you applying for? (please list for each child separately)
Costs: Total Classic Camp Tuition Costs for all children with NO DISCOUNTS/SCHOLARSHIPS*
Costs: Total Moshava Meyuchad Tuition Costs for all children with NO DISCOUNTS/SCHOLARSHIPS*
$

Funding:*

Rows	Funding
Parent Contribution
Congregation Contribution
Expected amount from ONE HAPPY CAMPER OR PJ LIBRARY
Other Sources
Discounts already received from Camp Moshava (early bird/new camper, etc)
Requesting from Camp Moshava
TOTAL

Rows	Mother	Father
2024-25 day school tuition
2024 -25 day school college costs
2024 camp costs

Rows	Name of children	Age	School	Grade/Year	Public/Private	Actual Cost for 2024-2025 School Year	Scholarship Received for 2024-2025 School Year	Tuition Paid for 2024-2025 School Year
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6

Rows	Mother 2024	Father 2024	Mother 2025	Father 2025	Mother Estimated 2026	Father Estimated 2026
1. Gross salaries and wages (including non-taxable retirement contributions and flexible benefits)
2. Dividend, interest and/or capital gains income (including non-taxable interest)
3. Other income (profit from business, rent, royalties, trusts, unemployment compensation, Social Security benefits, scholarship, etc.)

Rows	2024	2025	Estimated 2026
4. Parsonage (do not include with salary above)
5. Alimony/maintenance
6. Child support for all children
7. Public aid, food stamps, SSI (disability, death benefits, etc. received by family members)

Rows	AMOUNT
Checking/savings account(s)
Money markets/CD’s
Stocks/bonds/mutual funds
Real estate (not including family residence)/business
Retirement (pension funds, 401(k), IRA, tax deferred annuity, etc.)
Trust funds
Other (specify type & amount)

Rows	Make/model	Year	Leased/owned	Provided by employer
Car 1
Car 2
Car 3
Car 4

Rows	Business/Personal	Source of Debt	Initial Amount	Amount Remaining	Amount to be repaid in 2026
Debt 1
Debt 2
Debt 3
Debt 4

Scholarship Application 2026

Families will be charged monthly based on the tuition pricing until a FULL SCHOLARSHIP APPLICATION HAS BEEN SUBMITTED.