Temple Isaiah Scholarship Application

These are need-based grants for community members. To complete this form, you will need to provide contact information, information about the experience, including dates, information about your financial situation, how much you are requesting and if you are requesting scholarship funding from any other sources.

Many questions can be answered in our Temple Isaiah Scholarship Guidelines. For any other inquiries about the scholarship process, please contact Judy Shapiro, Acting Executive Director, or call 781-862-7160.

* In what type of experience do you plan to participate?

* Applicant Name (First)

* Applicant Name (Last)

* Address (Street)

* Address (City)

* Address (State)

* Address (Zip)

Home Phone

* Cell Phone

For teen applicants, please use teen's contact information.

* Email

For teen applicants, please use teen's contact information.

Adult Contact (First and Last Name)

Adult Contact Information

For teen applicants, please include parent/guardian contact information.

* Relationship to Applicant

Experience Information
Please provide us with information about the experience for which you seek funding.

* Name of Experience/Organization

What is the name of the experience/organization/camp/trip in which you plan to participate?

* Location of Program

City, State, Country if applicable.

* Experience/Sponsoring Organization Website

* Programs Dates (or duration, if exact dates are unknown)

Scholarship Request

* What is the full cost of the program/experience?

* Amount requesting from Temple Isaiah

* Amount requested/ing from other sources

Have you requested scholarship funding for this experience from additional outside sources, such as CJP or the program? If so, from whom and how much?

* Scholarship check should be made payable to:

* Where should the scholarship be sent?

Additional Information

* This is a needs based scholarship. Please share the circumstances regarding your financial situation in the space provided below.

All information provided will remain confidential. To discuss further, you may contact Judy Shapiro, Acting Executive Director, at j shapiro@templeisaiah.net for a confidential conversation.

* Electronic Signature (your initials)

* Date

Thu, April 25 2024 17 Nisan 5784