Jewish Foundation of Cincinnati

Grant Application Form (College)

2 Photos Required

Please Print Clearly

Date:________________

I hereby apply for a grant for the following Israel Program:

____________________________________________________________________________________________________

for the time period____________ through_____________ , 19_______

Applicant’s Name:_____________________________________________________________________________________

Address:_____________________________________________________________________________________________

(Street) (City/State/Zip)

Phone: ( ) Date of Birth: / /

Name of College:____________________________________________ Year or Year of Graduation:____________________

Synagogue/Temple affiliation:____________________________________________________________________________

List Three Person References:

1.________________________________________________________________ Phone:_____________________________

2.________________________________________________________________ Phone:_____________________________

3.________________________________________________________________ Phone:_____________________________

List your activities in the Jewish community:________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

Have you been to Israel before? Yes No If yes, when?_______________________________________

Program:_____________________________________________________________________________________________

How did you hear about the program?______________________________________________________________________

_____________________________________________________________________________________________________

Father Mother

Name _______________________________________________ ________________________________________

Occupation _______________________________________________ ________________________________________

Employer _______________________________________________ ________________________________________

Please write a short paragraph giving your reasons for requesting a grant from the Jewish Foundation Fund.

I hereby affirm the information on this application to be true to the best of my knowledge.

___________________________________________________ __________________________________________________

(Applicant’s signature) (Parent or Guardian)

The Jewish Foundation believes in you. You are an investment in the future of the Jewish people. It is hoped that the Shlicha can feel free to call on you for help in programs and activities during the year following your trip to Israel. I agree to fill out a short survey for the next 10 years, and I agree to provide my current address to the Jewish Foundation. I understand that this will be used only for this one purpose.

__________________________________________________ _____________________________________________________

(Applicant’s signature) (Parent or Guardian)

Please return by mail to:

Israel Programs

4380 Malsbary Road, Suite 200

Cincinnati, OH 45242

(513) 985-1520 or 985-1528

Fax: (513) 985-1503