Request for Camp Grant
Thank you for your interest in Camp Simcha! Please fill out this short form and we will get back to you shortly regarding your scholarship eligibility.
How did you hear about Camp Simcha?
Name (Parent #1) *
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Occupation (Parent #1) *
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Email Address (Parent #1)
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Name (Parent #2)
Your answer
Occupation (Parent #2)
Your answer
Email Address (Parent #2)
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Street Address *
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City *
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Zip *
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Home Telephone *
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Cell
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Number of Dependent Children (total) *
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Name(s) of children attending camp and preferred sessions
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Please briefly explain the reason for requesting a scholarship *
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This Form Completed By:
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Date
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