Juda Hebrew School Scholarship Application

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Phone Number:

Area Code Phone Number
Father/Guardian Information:
Full Name:*

First Name Last Name
E-mail:*
Phone Number:

Area Code Phone Number
Employer:
Years there:
Mother/Guardian Information:
Full Name:*

First Name Last Name
E-mail:*
Phone Number:

Area Code Phone Number
Employer:
Years there:
Scholarship Information:

This information is used to help determine eligibility. Applications are held in the strictest confidence.
Explain your need for scholarship assistance. List any unusual circumstances that the committee should know about.*
I would like to apply for:*

Full tuition scholarship of $500 per student Partial scholarship of $400 per student Partial scholarship of $300 per student Partial scholarship of $200 per student Partial scholarship of $100 per student None. I would like to pay by monthly installments
I can pay in monthly installments of:
Chabad Jewish Community Center will contact you regarding this application.
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Student Information: