Jewish Foundation of Cincinnati

Grant Application Form (High School)

                                                                                               

 

 

 

 

2 Photos Required

Please Print Clearly

 

Date:________________

 

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

____________________________________________________________________________________________________

for the time period____________ through_____________ , 20_______

 

Applicant’s Name:_____________________________________________________________________________________

Address:_____________________________________________________________________________________________

                        (Street)                                                                                                            (City/State/Zip)

Phone: (      )                                                                 Date of Birth:        /       /           

Name of High School:________________________________________ 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, thereby benefiting from your experience.  I agree to fill out a short annual survey for the next 10 years, and to provide my current address to the Jewish Foundation.  I understand that this will be used only for this one purpose. 

 

I agree to participate in a pre-trip program at __________________________________.

 

 

___________________________________________________                                                                                                __________________________________________________

 (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