Scholarship Application

Personal Information

Family Name *

Street Address *

Cell Phone *

Email *

Mothers Name *

Mothers Occupation *

Fathers Name *

Fathers Occupation *

Financial Information

I can afford to pay $___ Per month of Park Hebrew (Per Child) * Full tuition is $1,500/year per child

Please indicate why you feel a scholarship should be granted to you.

I Hereby give Park Hebrew permission to verify my place of employment, childrens schools or any other relevant information.

Yes

No