Youth Education Tuition Assistance Application Form

Youth Education Scholarship Application

Peninsula Temple Sholom strives to make youth programming available to all children within our PTS community. We recognize that from time to time, needs-based financial assistance may be required and we encourage you to apply if you are in need. Please note that all information will be kept strictly confidential.

* I am applying for:

* How many children are covered by this application?

* Child 1 - Full Name

* Child 1 - Date of Birth

* Child 1 - Grade Entering Fall 2025

* Child 1 - Last year's school, if not PTS

* Child 2 - Full Name

* Child 2 - Date of Birth

* Child 2 - Grade Entering Fall 2025

* Child 2 - Last year's school, if not PTS

* Child 3 - Full Name

* Child 3 - Date of Birth

* Child 3 - Grade Entering Fall 2025

* Child 3 - Last year's school, if not PTS

* Guardian 1 - First Name

* Guardian 1 - Last Name

* Guardian 1 - Email

* Guardian 1 - Mobile Phone

* Guardian 1 - Address

* Guardian 1 - City

* Guardian 1 - State

* Guardian 1 - Zip Code

Guardian 1 - Employer

Guardian 1 - Business Address

Guardian 1 - How long? (years)

* Is there a second adult living in the household?

* Guardian 2 - First Name

* Guardian 2 - Last Name

* Guardian 2 - Email

* Guardian 2 - Mobile Phone

Guardian 2 - Employer

Guardian 2 - Business Address

Guardian 2 - How long? (years)

Please describe your family's situation and any other circumstances that may be exceptional and that necessitate the need for financial assistance in the box below. Include a discussion of your family's annual income and fixed expenses. Please be as specific as possible to help us understand your needs.

* Anticipated Tuition Cost ($)

* Amount I can contribute ($)

* Amount I am requesting in scholarship ($)

* I certify that all information provided on this form is accurate and complete.

We are grateful to all the donors who make Youth Education tuition assistance possible.

Thu, May 1 2025 3 Iyar 5785

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Youth Education Tuition Assistance Application Form

Youth Education Scholarship Application

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