LJY-Netzer Bursary Application Form
LJY-Netzer is passionate about inclusivity, including financial inclusivity, and does not want any young person to miss out on an LJY-Netzer event for financial reasons.  We therefore operate a bursary scheme for families who are not able to pay the full cost.  Please complete the fields below, providing as much information as possible.

If you are sending more than one child on an event, please complete this form once only .  Do not submit additional forms for other siblings.

The information provided in this form will be seen only by Becca Fetterman (Director of Youth Students and Young Adults) and Shelley Shocolinsky-Dwyer (Director of operations), plus other Liberal Judaism staff on a strict need-to-know basis.  The information will be held in confidence and destroyed after the event.

If you have any questions about completing the form, please contact Becca Fetterman in confidence on 020 7631 9831 or ljynetzerbursaries@gmail.com.
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Event for which you are applying *
Name(s) of child(ren) participating in the event: *
Contact Information
Please give us the details of the parent/guardian who can be contacted in relation to this applciaiton.
Name of parent/guardian *
Phone number *
Email address *
Synagogue Membership
Does your family have membership of a Liberal Judaism synagogue? *
If yes, which one?
Are you a member of any other synagogue(s)? *
If yes, which one(s)?
I give permission for Liberal Judaism to contact my synagogue(s) about financial assistance. *
Financial Information
Please tell us about the income of parent/guardian 1 *
Please tell us about the income of parent/guardian 2 *
Do you have any other children who are not participating?  What are their ages? *
Please give us any other information that you feel is relevant *
Please note the total amount of money that you can afford to pay for this event *
Declaration *
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