2019 New York Teen Initiative - Summer Programs Scholarship
First Name of Teen Applicant *
Your answer
Last Name of Teen Applicant *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Telephone Number *
Your answer
Participant's Email Address *
Your answer
Parent's Email Address *
Your answer
Parent's Email Address (2)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age of Teen *
Your answer
Grade of Teen as of September 2018 (Current Grade) *
Which ethnicity do you identify with? *
What denomination of Judaism do you identify with? *
Share a few sentences about the participant's family background and Jewish involvement. *
Your answer
Has the teen applicant ever participated in an immersive Jewish summer experience? If yes, what was the context and timeframe? (If they have not, say none) *
Your answer
What BBYO program are you registered for? *
Your answer
What is total cost of the program (including airfare)? *
Your answer
When is the departure date of the program? *
MM
/
DD
/
YYYY
Where else have you applied for financial assistance from other organizations and how much is expected? (If not, write None) *
Your answer
How much can your family afford to pay toward the cost of the program? *
Your answer
How much financial assistance are you requesting from the New York Teen Initiative (NYTI) on behalf of this applicant? *
Your answer
Is the (NYTI) scholarship being used as an incentive for the participant to join the trip? *
We are currently gathering data around veterans. Does a veteran reside in the teen applicants home? *
I understand that in order for this application to considered, a copy of my most recent IRS form 1040 from my tax return must be submitted to info@bbyopassport.org or faxed to 202.315.3908. If you are applying for Israel Scholarship, please also apply for BBYO Passport scholarship form in your account. *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Authentic Israel. Report Abuse - Terms of Service