Temple Beth Shalom Financial Assistance Application
Temple Beth Shalom Children's Center offers limited need based financial assistance. To apply, please complete the form below and upload a copy of your most recent federal tax form (front page only) or email to Ellen Dietrick, Director of Early Childhood Learning, edietrick@tbsneedham.org.

Please submit your application by Friday, January 4. The financial assistance committee will determine awards in early February.

Email address *
Name
Briefly describe the situation of financial difficulty
Number in your household
Total family income for last year (2017)
Total family income for this year (2018)
My family’s total Temple Beth Shalom financial commitment for 2019-20 before any adjustment includes the following
Of the total above, I am able to pay
Upload front page of 2017 tax return (or email to Ellen Dietrick edietrick@tbsneedham.org)
In requesting financial assistance, I confirm that we would like to be or continue to be part of the Temple Beth Shalom community, but are unable to pay the full costs for our member commitment and/or tuition expenses. I also confirm that all of the information we have provided is true. In accepting financial assistance, I promise that I will consistently make agreed upon payments.
A copy of your responses will be emailed to the address you provided.
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