Sussman-Shenker Scholarship Application 2026
General Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Female
Male
Other
Back
Next
Family Information
Parent 1 Name
*
First Name
Last Name
Parent 2 Name
First Name
Last Name
Sibing(s) Full Names (if none, enter N/A)
*
Dependent(s) Full Names (if none enter N/A)
*
Back
Next
Involvement & School
Please include any involvement you've had with Jewish organizations (e.g. synagogues, camp, youth groups, etc.)
*
Extra-curricular Activities (Please list):
*
Please select one of your activities from either the Jewish or secular community and describe your involvement:
*
How does your Jewish identity impact or shape you? Please give an example. (250 word max)
*
Intended or Current College:
*
College Status (Choose one)
*
Full-time
Part-time
Other
Year in school for which you are applying:
*
Freshman
Sophomore
Junior
Senior
Current GPA
*
How would receiving this award impact you and your family?
*
If you are selected for this scholarship, may we publish your name?
*
Yes
No
How did you hear about the Sussman-Shenker Fund Scholarship?
*
Any other information you'd like us to consider?
Back
Next
Reference Information
First Reference Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Second Reference Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Letters of Reference if Available. Otherwise please submit by March 3rd, 2025
Browse Files
Cancel
of
Submit
Should be Empty: