Scholarship Application

Yad Menachem Scholarship Application

Mother

First Name *

Gender

Last Name *

Street Address *

Address Line 2

City *

Postal Code *

State/Province *

Phone Number *

Email *

Parents marital status

Parents are married

Father

Gender

First Name *

Last Name *

Street Address

Address Line 2

City

Postal Code

State/Province

Phone Number

Email *

Relationship between parents

How many kids are you applying for? *

Child 1

First Name *

Last Name *

Address *

Birth Date *

Month

Day

Year

Gender *

Current School *

Jewish school you want to apply to *

Requested tuition amount for this child (after all school discounts and outside scholarships) *

Maximum amount you can pay (for this child) *

Child 2

First Name *

Last Name *

Address *

Birth Date *

Month

Day

Year

Gender *

Current School *

Jewish school you want to apply to *

Requested tuition amount for this child (after all school discounts and outside scholarships) *

Maximum amount you can pay (for this child) *

Child 3

First Name *

Last Name *

Address *

Birth Date *

Month

Day

Year

Gender *

Current School *

Jewish school you want to apply to *

Requested tuition amount for this child (after all school discounts and outside scholarships) *

Maximum amount you can pay (for this child) *

Child 4

First Name *

Last Name *

Address *

Birth Date *

Month

Day

Year

Gender *

Current School *

Jewish school you want to apply to *

Requested tuition amount for this child (after all school discounts and outside scholarships) *

Maximum amount you can pay (for this child) *

Any Additional school age children? (Prescool-12)

There are more school age children (Kindergarten-12th grade) in the family that i'm not applying for

PLEASE PROVIDE THEIR NAMES, AGES, AND SCHOOLS *

Synagogue Affiliation

Synagogue you are affiliated with *

Attending a synagogue is not a qualification for assistance, it is just for us to understand the demographic we serve and your needs. You can write not affiliated if you do not regularly attend a synagogue.

Synagogue Contact Name

Name of the synagogue's Rabbi, or any other reference.

Synagogue Contact Phone

Phone of the synagogue's Rabbi, or any other reference. (Numbers only! no spaces or dashes etc.)

Household Financials

Why you request financial assistance *

Yad Menachem is happy to help anyone who feels they need assistance to afford Jewish day school tuition provided they are first approved for financial aid at the school of their choice. If there is a challenge getting financial aid from the school we can at times be of assistance in speaking to the school on your behalf.